A 50-year-old male who is known to abuse alcohol is seen
in clinic. He complains of abdominal discomfort and being generally unwell. He
has never had haematemesis or melaena. He is an asthmatic and uses a
salbutamol inhaler as required in addition to twice daily inhaled
On examination he was noted to have several spider naevi
on his upper chest. He had gynaecomastia and examination of his abdomen
You arrange an upper gastrointestinal endoscopy to screen
for varices and the endoscopist reports the presence of 3 small non-tortuous
varices and portal hypertensive gastropathy.
In this patient which of the following would you use to
prevent variceal haemorrhage?