Lv Y, et al. - Researchers conducted an investigator-initiated, open-label, randomised controlled trial to ascertain if early transjugular intrahepatic portosystemic shunts (TIPS) improves survival in patients with advanced cirrhosis and acute variceal bleeding. For this investigation, 373 patients were screened and 132 patients were randomly assigned to the early TIPS group (n=86) or to the control group (n=46) from June 26, 2011, to September 30, 2017. In the early TIPS group, transplantation-free survival was higher than in the control group. No significant differences were found between the two groups in the incidence of hepatic hydrothorax, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome, and hepatocellular carcinoma. In chosen patients with advanced cirrhosis and acute variceal bleeding, early TIPS with covered stents improved transplantation-free survival and should, therefore, be preferred to the current standard of care.