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目的:探讨有症状颅内椎基底动脉狭窄患者血管重构模式与支架置入术后穿支卒中的相关性。方法:回顾性纳入2017年1月至2020年8月在武汉大学中南医院神经内科行支架置入术且接受高分辨率磁共振成像(high-resolution magnetic resonance imaging, HR-MRI)检查的有症状颅内椎基底动脉粥样硬化性狭窄患者。收集人口统计学、血管危险因素、斑块特征、手术过程及术后并发症等资料，通过HR-MRI观察斑块特征，分析血管重构模式与支架置入术后穿支卒中的相关性。结果:共41例患者纳入分析，年龄(60.1±8.8)岁(范围49～77岁)，男性31例(75.6%)。其中21例(51.2%)为正性重构，20例(48.8%)为非正性重构；5例(12.2%)术后发生穿支卒中。正性重构组穿支卒中发生率显著高于非正性重构组(23.8%对0%；n P＝0.048)。穿支卒中组正性重构率显著高于非穿支卒中组(100.0%对44.4%；n P＝0.048)。n 结论:血管正性重构的颅内椎基底动脉粥样硬化性狭窄患者支架置入术后更易发生穿支卒中。“,”Objective:To investigated the correlation between vascular remodeling pattern and perforator stroke after stenting in patients with symptomatic intracranial vertebrobasilar artery stenosis.Methods:Patients with symptomatic intracranial vertebrobasilar atherosclerotic stenosis underwent stenting and high resolution magnetic resonance imaging (HR-MRI) from January 2017 to August 2020 were enrolled retrospectively. The data of demography, vascular risk factors, plaque characteristics, operation process and postoperative complications were collected. The plaque characteristics were observed by HR-MRI, and the correlation between vascular remodeling pattern and perforator stroke after stenting was analyzed.Results:A total of 41 patients were enrolled in the analysis. Their age was 60.1±8.8 years (range, 49-77 years). There were 31 males (75.6%). Among them, 21 (51.2%) were positive remodeling, 20 (48.8%) were non-positive remodeling, and 5 (12.2%) had perforator stroke after procedure. The incidence of perforator stroke in the positive remodeling group was significantly higher than that in the non-positive remodeling group (23.8% n vs. 0%; n P=0.048). The positive remodeling rate of the perforator stroke group was significantly higher than that of the non-perforator stroke group (100.0% n vs. 44.4%; n P=0.048).n Conclusions:Patients with intracranial vertebrobasilar atherosclerotic stenosis and positive vascular remodeling were more likely to have perforator stroke after stenting.