A total of 50 patients will be enrolled and will be randomized into either Group A(TIPS) or Group B (SEMS).

Primary end point of the study will be to compare efficacy of TIPS versus SEMS for survival at 6 week or Early re Bleed. All enrolled patients will also undergo HVPG measurement at baseline to stratify risk of failure to control bleed or early re-bleed.

Patient will be monitored for 5 days for re bleed, complications of therapy, worsening of Liver function tests and scores and efficacy of either treatment modality over other. Patient will be followed for 6 weeks to see for the primary end point.

Inclusion Criteria:

- Consecutive patients of cirrhosis aged 18-70 years presenting with acute variceal Bleeding, who on endoscopy fail to control bleed or rebleeds within 5 days will be randomized.

Exclusion Criteria:

• Bleeding from non-variceal source
• Coagulopathy related bleed
• Bleeding from Gastric varices
• Any malignancy including HCC
• Main Portal vein thrombosis
• Patients in refractory shock
• Patients with severe cardiopulmonary disease
• Grade 4 Hepatic encephalopathy
• MELD > 25
• Multiorgan failure
• Active sepsis
• Pregnancy
• Failure to give consent