C

Endoscopic band ligation and vasoactive agents such as octreotide are first-line therapies for acute variceal bleeding, and TIPS is employed as salvage/early pre-emptive therapy when standard measures fail [Garcia-Pagán 2012 PMID 22447260; Loffroy 2015 PMID 26094039; Abraldes 2004 PMID 14997222]. Routine platelet transfusion is not part of guideline-directed management; studies show it offers no benefit and may even increase early re-bleeding, so it is generally avoided unless profound thrombocytopenia exists [Biswas 2022 PMID 36158909].