{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T11:27:44Z","timestamp":1791026864933,"version":"4.1.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:p>\n                    Balloon tamponade is recommended only as a \u201cbridge\u201d to definitive therapy in patients with cirrhosis and massive or refractory esophageal variceal bleeding (EVB), but is frequently associated with rebleeding and severe complications. Preliminary, noncontrolled data suggest that a self\u2010expandable, esophageal covered metal stent (SX\u2010ELLA Danis; Ella\u2010CS, Hradec Kralove, Czech Republic) may be an effective and safer alternative to balloon tamponade. We conducted a randomized, controlled trial aimed at comparing esophageal stent versus balloon tamponade in patients with cirrhosis and EVB refractory to medical and endoscopic treatment. Primary endpoint was success of therapy, defined as survival at day 15 with control of bleeding and without serious adverse events (SAEs). Twenty\u2010eight patients were randomized to Sengstaken\u2010Blakemore tube (n = 15) or SX\u2010ELLA Danis stent (n = 13). Patients were comparable in severity of liver failure, active bleeding at endoscopy, and initial therapy. Success of therapy was more frequent in the esophageal stent than in balloon tamponade group (66% vs. 20%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.025). Moreover, control of bleeding was higher (85% vs. 47%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u20090.037) and transfusional requirements (2 vs 6 PRBC;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.08) and SAEs lower (15% vs. 47%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.077) in the esophageal stent group. TIPS was used more frequently in the tamponade group (4 vs. 10;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.12). There were no significant differences in 6\u2010week survival (54% vs. 40%;\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = 0.46).\n                    <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                    Esophageal stents have greater efficacy with less SAEs than balloon tamponade in the control of EVB in treatment failures. Our findings favor the use of esophageal stents in patients with EVB uncontrolled with medical and endoscopic treatment. (H\n                    <jats:sc>epatology<\/jats:sc>\n                    2016;63:1957\u20101967)\n                  <\/jats:p>","DOI":"10.1002\/hep.28360","type":"journal-article","created":{"date-parts":[[2015,11,24]],"date-time":"2015-11-24T11:34:55Z","timestamp":1448364895000},"page":"1957-1967","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":219,"title":["Esophageal balloon tamponade versus esophageal stent in controlling acute refractory variceal bleeding: A multicenter randomized, controlled trial"],"prefix":"10.1097","volume":"63","author":[{"given":"\u00c0ngels","family":"Escorsell","sequence":"first","affiliation":[{"name":"Liver Unit,Hospital Cl\u00ednic,Barcelona"},{"name":"CIBERehd,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana","family":"Pavel","sequence":"additional","affiliation":[{"name":"CIBERehd,Barcelona,Spain"},{"name":"Hospital de la Santa Creu i Sant Pau,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s","family":"C\u00e1rdenas","sequence":"additional","affiliation":[{"name":"CIBERehd,Barcelona,Spain"},{"name":"GI\/Endoscopy Unit,Hospital Cl\u00ednic,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Morillas","sequence":"additional","affiliation":[{"name":"CIBERehd,Barcelona,Spain"},{"name":"Hospital Germans Trias i Pujol,Badalona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elba","family":"Llop","sequence":"additional","affiliation":[{"name":"CIBERehd,Barcelona,Spain"},{"name":"Hospital Puerta de Hierro,Madrid,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e0ndid","family":"Villanueva","sequence":"additional","affiliation":[{"name":"CIBERehd,Barcelona,Spain"},{"name":"Hospital de la Santa Creu i Sant Pau,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C.","family":"Garcia\u2010Pag\u00e1n","sequence":"additional","affiliation":[{"name":"Liver Unit,Hospital Cl\u00ednic,Barcelona"},{"name":"CIBERehd,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Bosch","sequence":"additional","affiliation":[{"name":"Liver Unit,Hospital Cl\u00ednic,Barcelona"},{"name":"CIBERehd,Barcelona,Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"; for the Variceal Bleeding Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2016,1,14]]},"reference":[{"key":"hep28360-bib-0001-20241017","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1055\/s-0032-1301734","article-title":"Acute variceal bleeding","volume":"33","year":"2012","journal-title":"Semin Respir Crit Care Med"},{"key":"hep28360-bib-0002-20241017","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1016\/j.jhep.2010.06.004","article-title":"Revising consensus in portal hypertension: report of the Baveno V Consensus Workshop on methodology of diagnosis and therapy in portal hypertension","volume":"53","year":"2010","journal-title":"J Hepatol"},{"key":"hep28360-bib-0003-20241017","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.jhep.2015.05.022","article-title":"Expanding consensus in portal hypertension: report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension","volume":"63","year":"2015","journal-title":"J Hepatol"},{"key":"hep28360-bib-0004-20241017","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1053\/jhep.2002.31354","article-title":"Endoscopic treatment versus endoscopic plus pharmacologic treatment for acute variceal bleeding: a meta\u2010analysis","volume":"35","year":"2002","journal-title":"Hepatology"},{"key":"hep28360-bib-0005-20241017","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1053\/jhep.2002.34737","article-title":"Meta\u2010analysis of trials for variceal bleeding","volume":"36","year":"2002","journal-title":"Hepatology"},{"key":"hep28360-bib-0007-20241017","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.cld.2010.03.012","article-title":"Refractory acute variceal bleeding: what to do next?","volume":"14","year":"2010","journal-title":"Clin Liver Dis"},{"key":"hep28360-bib-0008-20241017","first-page":"566","article-title":"Esophageal tamponade for bleeding varices. 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