Comparing blood thinners for people with cirrhosis and portal vein clots

Efficacy and Safety of Anticoagulant Therapy for Portal Vein Thrombosis In Cirrhosis Patients With and Without Hepatocellular Carcinoma

This will try enoxaparin, warfarin, or apixaban in people with cirrhosis and portal vein thrombosis (with or without liver cancer) to see which controls the clot and is safest.

Quick facts

• Phase: PHASE4
• Study type: Interventional
• Enrollment: 100 (estimated)
• Ages: 18 Years to 70 Years
• Sex: All
• Sponsor: Mansoura University (other)
• Locations: 1 site (Al Mansurah, Dakahlia Governorate)
• Trial ID: NCT07132515 on ClinicalTrials.gov

What this trial studies

Adults with cirrhosis (Child‑Pugh A or B) who have portal vein thrombosis, with or without hepatocellular carcinoma, will receive one of three anticoagulants (enoxaparin, warfarin, or apixaban) and be followed over time. The study will monitor clot resolution, bleeding complications, and other safety outcomes while excluding those with very low platelets, significant renal impairment, Budd‑Chiari syndrome, or uncontrolled active bleeding. As a Phase 4 interventional trial at Mansoura University Hospitals, it compares drugs already in clinical use rather than testing a new agent. Imaging and laboratory follow-up will be used to detect recanalization and adverse events.

Who should consider this trial

Good fit: Ideal candidates are adults with cirrhosis (Child‑Pugh A or B) and portal vein thrombosis, with or without hepatocellular carcinoma, who do not have severe renal failure, extremely low platelets, active uncontrolled bleeding, or Budd‑Chiari syndrome.

Not a fit: Patients with creatinine >1.9 mg/dL, platelets <10,000, uncontrolled active bleeding, or Budd‑Chiari syndrome are excluded and unlikely to benefit from participation.

Why it matters

Potential benefit: If successful, the results could clarify which commonly used blood thinner offers the best balance of clot resolution and safety for patients with cirrhosis and portal vein thrombosis.

How similar studies have performed: Previous studies have shown that anticoagulation can promote recanalization of portal vein thrombosis in cirrhosis and reduce progression, and emerging data suggest direct oral anticoagulants like apixaban may be effective but are less extensively studied than heparins or warfarin.

Eligibility criteria

Inclusion Criteria:

* Portal vein thrombosis, Cirrhosis, With or without HCC, Child A \& B

Exclusion Criteria:

* Platelets\<10000, Createnine \>1.9, Budd ciarri, Uncontrolled active bleeding

Where this trial is running

Al Mansurah, Dakahlia Governorate

• Mansoura University Hospitals — Al Mansurah, Dakahlia Governorate, Egypt (RECRUITING)

Study contacts

• Study coordinator: Dalia Elsayed Ganady, MBBS

Conditions: Cirrhosis, HCC - Hepatocellular Carcinoma, Portal Vein Thrombosis