Abstract: Objective The aim of this study was to investigate the efficacy and safety of rivaroxaban as an oral anticoagulant in patients with Budd Chiari syndrome after percutaneous intravascular intervention (PII). Methods The clinical data of 103 patients with Budd Chiari syndrome who met the inclusion and exclusion criteria between December 2017 and April 2020 were retrospectively analyzed. All patients underwent PII, and were divided into two groups, taking rivaroxaban (n=49) or aspirin (n=54) as the anticoagulants after operation. The endpoint was mortality and/or massive bleeding. Results After operation, the average follow-up period in rivaroxaban- and aspirin-treated groups were 20.33±6.31 months and 19.43±6.34 months (P＞0.05); at the end of 6 month, 12 month and 20 month, the stent patency rates in the rivaroxaban-treated groups were significantly higher than those in aspirin-treated group, e.g. 93.9% vs. 85.2%, 89.8% vs. 81.5% and 87.8% vs. 74.1%(all P=0.044); there were no significant differences as respect to massive bleeding free rates at 6 month, 12 month and 20 month in the two groups (95.9%, 91.8% and 87.8% vs. 88.9%, 87.0% and 19.6%, P>0.5); the survival rates at 6-month, 12-month and 20-month in rivaroxaban-treated group were 95.9%, 91.8% and 85.7%, not significantly different compared to 94.4%, 88.9% and 81.5% in aspirin-treated group (P=0.681); the endpoint mortality and/or massive bleeding free event in rivaroxaban-treated group were 95.9%, 89.8% and 83.7%, not significantly different compared to 88.9%, 87.0% and 81.5% in aspirin-treated group (P=0.675). Conclusion Compared with aspirin, rivaroxaban could improve stent patency in patients with Budd Chiari syndrome after PII, and might not increase massive bleeding, which is worthy of further clinical investigation.

Key words: Budd-Chiari syndrome, Percutaneous intravascular intervention, Transjugular intrahepatic portosystemic shunt, Rivaroxaban, Anticoagulants