EVL followed by APC did not offer significant advantages over EVL alone with respect to obliteration of esophageal varices and their recurrence over a 6 months period of follow up.Increased esophageal variceal grade was observed more in the EVL alone group and may significant differences occur between both methods if the follow up period is prolonged.No significant complications were added to EVL from the use of APC in the distal esophagus.