{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:57:44Z","timestamp":1785326264917,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"11-12","license":[{"start":{"date-parts":[[2015,10,16]],"date-time":"2015-10-16T00:00:00Z","timestamp":1444953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The prognosis of patients with cirrhosis and acute variceal bleeding is very poor when the standard\u2010of\u2010care fails to control bleeding. New treatment modalities are needed in these patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To synthesise the available evidence on the efficacy of self\u2010expanding metal stents (<jats:styled-content style=\"fixed-case\">SEMS<\/jats:styled-content>) in patients with cirrhosis and severe or refractory oesophageal variceal bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Meta\u2010analysis of trials evaluating <jats:styled-content style=\"fixed-case\">SEMS<\/jats:styled-content> in patients with cirrhosis and severe or refractory oesophageal variceal bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirteen studies were included. The pooled estimate rates were 0.40 (95% confidence interval, <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00.31\u20130.49) for death, 0.41 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00.29\u20130.53) for liver\u2010related death and 0.36 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00.26\u20130.47) for death at day 30, with low heterogeneity between studies. The pooled estimate rates were 0.12 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00.07\u20130.21) for mortality related to variceal bleeding, and 0.18 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00.11\u20130.29) for failure to control bleeding with <jats:styled-content style=\"fixed-case\">SEMS<\/jats:styled-content>, with no or low heterogeneity between studies. The pooled estimate rate were 0.16 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00.04\u20130.48) for rebleeding after stent removal and 0.28 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00.17\u20130.43) for stent migration, with high heterogeneity. A significant proportion of patients had access to liver transplantation or to <jats:styled-content style=\"fixed-case\">TIPSS<\/jats:styled-content> [pooled estimate rate 0.10 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00.04\u20130.21) and 0.26 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\u00a0=\u00a00.18\u20130.36), respectively].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Fewer than 40% of patients treated with <jats:styled-content style=\"fixed-case\">SEMS<\/jats:styled-content> were dead at 1\u00a0month. <jats:styled-content style=\"fixed-case\">SEMS<\/jats:styled-content> can be used as a bridge to <jats:styled-content style=\"fixed-case\">TIPSS<\/jats:styled-content> or to liver transplantation in a significant proportion of patients. Additional studies are required to identify potential risk factors leading to a poor prognosis in patients with <jats:styled-content style=\"fixed-case\">acute variceal bleeding<\/jats:styled-content> in whom the use of <jats:styled-content style=\"fixed-case\">SEMS<\/jats:styled-content> could be considered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13424","type":"journal-article","created":{"date-parts":[[2015,10,16]],"date-time":"2015-10-16T03:25:11Z","timestamp":1444965911000},"page":"1250-1260","source":"Crossref","is-referenced-by-count":43,"title":["Systematic review with meta\u2010analysis: self\u2010expanding metal stents in patients with cirrhosis and severe or refractory oesophageal variceal bleeding"],"prefix":"10.1111","volume":"42","author":[{"given":"A.","family":"Marot","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Centre Hospitalier Universitaire Vaudois University of Lausanne Lausanne 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