Abstract: Objective　To explore the influence factors of anti-thrombotic therapy in patients with ischemic stroke (IS) complicated with calf muscular vein thrombosis (CMVT). Methods　A total of 149 patients with IS complicated with CMVT were divided into the non-rivaroxaban group (n=67) and the rivaroxaban group (n=82) according to whether they were treated with rivaroxaban or not. The clinical baseline data were collected and compared between the two groups. After treatment, ineffective events and bleeding events were recorded in the 2 groups, and the risk factors of ineffective events and bleeding events were analyzed by Logistic regression. Results　In the non-rivaroxaban group, the proportion of creatinine clearance rate(CLcr)＜50 mL/min, National Institutes of Health Stroke Scale (NIHSS) score, complicated coronary heart disease, old cerebral hemorrhage, history of gastric ulcer, history of infection, using aspirin together, 1.4 mmol/L＜low density lipoprotein cholesterol (LDL-C)≤1.8 mmol/L and non high density lipoprotein cholesterol (non-HDL-C)＜2.2 mmol/L were significantly higher than those of the rivaroxaban group, and the proportion of 1.8 mmol/L＜LDL-C≤2.6 mmol/L, combined hypertension and using statin were significantly lower (P＜0.05). The incidence of ineffective events was significantly higher in the non-rivaroxaban group than that in the rivaroxaban group, and the incidence of bleeding events was significantly lower than that in the rivaroxaban group (P＜0.01). Logistic regression analysis showed that rivaroxaban was not used and old cerebral hemorrhage were independent risk factors for ineffective events (P＜0.05), while using rivaroxaban and increased NIHSS score were independent risk factors for bleeding events (P＜0.05). Conclusion　Rivaroxaban can be used to reduce the incidence of ineffective events in IS patients with CMVT while increasing the incidence of bleeding events.

Key words: stroke, venous thrombosis, rivaroxaban, cerebral hemorrhage, influence factors, calf muscle venous thrombosis