Efficacy of Apixaban in the Treatment of Portal Vein Thrombosis Occurring More Than One Year After LS

Inclusion Criteria: 1. A clinical, radiological, or histologic diagnosis of cirrhosis of any etiology. 2. Splenomegaly with secondary hypersplenism. 3. No evidence of portal vein thrombosis by ultrasound evaluation and angio-CT prior to surgery. 4. Underwent laparoscopic splenectomy at our center. 5. Orally received 2.5 mg of apixaban (CTTQ, Nanjing, China) twice daily or a 100 mg aspirin tablet (Bayer, Leverkusen, Germany) once daily for 6 months from POD 3. 6. subcutaneous injections of low molecular weight heparin sodium (CSBio, Hebei, China) were administered for 5 days from POD 3 7. Oral dipyridamole (Henan Furen, Henan, China) at a dosage of 25 mg, administered three times daily for 3 months from POD 3. 8. Had no imaging evidence (Doppler ultrasound or CT) of portal vein thrombosis during postoperative months 6 to 12. 9. Developed portal vein thrombosis after 12 months post-surgery. 10. Provided informed consent to participate in the study. Exclusion Criteria: 1. Hepatocellular carcinoma or any other malignancy. 2. Hypercoagulable state other than the liver disease related. 3. DRUGS- oral contraceptives, anticoagulation or anti-platelet drugs. 4. Portal hypertension bleeding . 5. Child - Pugh C 6. Recent peptic ulcer disease 7. History of Hemorrhagic stroke 8. Pregnancy. 9. Uncontrolled Hypertension 10. Human immunodeficiency virus (HIV) infection