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Assessed for eligibility (n=137) TIPS (n=29) LVP + A (n=33) Analysed (n=29) Lost to follow-up (n=1 ) Analysed (n=33) Excluded (n=75)   Not meeting inclusion criteria (n=67)* Declined to participate (n=5)   Other reasons (n=3) Randomized (n=62) age > 70 20 ChildC>12 17 > 6 LVP 13 Complete PVT 4 Cardiac failure associated indication (prevention of rebleeding) HCC 5 Age > 70 (n = 20), Child Pugh score >12 (n=17), more than 6 large volume paracentesis within the previous 3 months (n = 13), complete portal vein thrombosis( n=4), cardiac failure or pulmonary hypertension (n=4), associated indication (prevention of rebleeding : n = 4), hepatocellular carcinoma (n = 5)