The Application of “Stilted Building” Technique in the Embolization of Aneurysms with Secondary Branches

Figure 1

Technical details of the “stilted building” technique. (a) The stilted buildings of the Chinese Tujia people feature a bamboo or wooden structure suspended above the ground and raised on timber stilts (arrow). (b) A branch originates from the neck of the aneurysm (arrow), and its blood flow direction is at an acute angle with the parent artery. It is difficult to protect it with a balloon or stent during the embolization of the aneurysm. (c) The aneurysm is embolized by using the “stilted building” technique; first, a double microcatheter is placed in the appropriate part of the aneurysm. (d) A coil with a diameter slightly larger than the aneurysm is used to form a support frame within the aneurysm, allowing several rings to enter the branch artery to play a supporting role (arrow). (e) The ruptured sac and body continue to be embolized with the supporting frame, avoiding the branch artery. The presence of the supporting frame allows subsequent coils to be held in a suitable position without entering the branch artery. The pillars of the “stilted building” are indicated by the solid ellipse, and the body of the “stilted building” is shown by the dotted ellipse.

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