Table 2.

Rescue therapies for refractory esophageal variceal bleeding.

Modality	Candidate	Efficacy in controlling bleeding	Complications	Limitation
BT	Refractory esophageal bleeding as bridge to definitive therapy.	More than 80% but tube should be removed within 24 hours.	Potentially lethal complications including esophageal perforation aspiration and pneumonia.	Limited efficacy and high complication rate in in-experienced hands. Temporary measure
Surgery	Acute variceal bleeding unresponsive to medical and endoscopic therapy.	Heterogeneous group but generally very effective.	Hepatic encephalopathy. Liver decompensation.	Requires expertise with exception of modified Sugiura procedure.
TIPS	Acute variceal bleeding unresponsive to medical and endoscopic therapy.	More than 90%.	Hepatic encephalopathy.	Limited availability
			Liver decompensation.	Occlusion and stenosis.
				Not suitable or contraindicated in many patients.
SEMSs	Refractory esophageal bleeding as bridge to definitive therapy.	70–100% and stent can be left in place for as long as 2 weeks.	Minor esophageal ulcer.	Temporary measures
			Migration.	Require a repeat endoscopy for removal.
			Compression of left main bronchus.