Efficacy of Apixaban in Treating Portal Vein Thrombosis Occurring More Than One Year After LSD

Inclusion Criteria: 1. A clinical, radiological, or histologic diagnosis of cirrhosis of any etiology. 2. Portal hypertension bleeding . 3. Splenomegaly with secondary hypersplenism. 4. No evidence of portal vein thrombosis by ultrasound evaluation and angio-CT prior to surgery. 5. Underwent laparoscopic splenectomy at our center. 6. 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. 7. subcutaneous injections of low molecular weight heparin sodium (CSBio, Hebei, China) were administered for 5 days from POD 3 8. Oral dipyridamole (Henan Furen, Henan, China) at a dosage of 25 mg, administered three times daily for 3 months from POD 3. 9. Had no imaging evidence (Doppler ultrasound or CT) of portal vein thrombosis during postoperative months 6 to 12. 10. Developed portal vein thrombosis after 12 months post-surgery. 11. 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. Child - Pugh C 5. Recent peptic ulcer disease 6. History of Hemorrhagic stroke 7. Pregnancy. 8. Uncontrolled Hypertension 9. Human immunodeficiency virus (HIV) infection