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

If portal vein thrombosis occurs more than one year after laparoscopic splenectomy, the patient will orally received 2.5 mg of apixaban (CTTQ, Nanjing, China) twice daily. Then, the efficacy of apixaban in treating portal vein thrombosis will be examined every three months using Doppler ultrasound screening or contrast-enhanced CT scans. If it is effective, the patient will continue to take apixaban.

Inclusion criteria

• A clinical, radiological, or histologic diagnosis of cirrhosis of any etiology.
• Splenomegaly with secondary hypersplenism.
• No evidence of portal vein thrombosis by ultrasound evaluation and angio-CT prior to surgery.
• Underwent laparoscopic splenectomy at our center.
• 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.
• subcutaneous injections of low molecular weight heparin sodium (CSBio, Hebei, China) were administered for 5 days from POD 3
• Oral dipyridamole (Henan Furen, Henan, China) at a dosage of 25 mg, administered three times daily for 3 months from POD 3.
• Had no imaging evidence (Doppler ultrasound or CT) of portal vein thrombosis during postoperative months 6 to 12.
• Developed portal vein thrombosis after 12 months post-surgery.
• Provided informed consent to participate in the study.

Exclusion criteria

• Hepatocellular carcinoma or any other malignancy.
• Hypercoagulable state other than the liver disease related.
• DRUGS- oral contraceptives, anticoagulation or anti-platelet drugs.
• Portal hypertension bleeding .
• Child - Pugh C
• Recent peptic ulcer disease
• History of Hemorrhagic stroke
• Pregnancy.
• Uncontrolled Hypertension
• Human immunodeficiency virus (HIV) infection