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DOI: 10.1055/s-0044-1791808
Our Experience with the Low-Profile Braided Occluder: A Case Series of Splenic Artery Embolization in Three Trauma Patients

Abstract
The spleen is the most injured intra-abdominal organ, with splenic injuries constituting 42 to 49% of all abdominal injuries. Due to this vulnerability and the fact that splenic ruptures can potentially result in life-threatening hemorrhage, finding quick and efficient ways to control splenic bleeding in a trauma setting can improve patient outcomes. Recently, the U.S. Food and Drug Administration cleared the low-profile braided occluder (LOBO; Okami Medical, Aliso Viejo, California, United States), a vascular occlusion system designed to rapidly occlude vessels by using a high-density, uniform small pore structure. We present a small case series describing the use of the LOBO device for proximal splenic embolization in three trauma patients. Our report suggests that the LOBO device is safe and efficient for proximal splenic artery embolization as all three of our patients had a successful outcome with no complications; furthermore, we believe using the LOBO device may enhance patient and provider safety by decreasing fluoroscopic time and radiation dose, though further studies are needed to support this.
Keywords
trauma - splenic embolization - interventional radiology - low-profile braided occluder (LOBO)Publication History
Article published online:
24 October 2024
© 2024. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Quencer KB, Smith TA. Review of proximal splenic artery embolization in blunt abdominal trauma. CVIR Endovasc 2019; 2 (01) 11
- 2 Moriarty HK, Clements W, Koukounaras J, Goh GS, Joseph T, Phan T. ArtVentive endoluminal occlusion system for proximal splenic artery embolization. Diagn Interv Radiol 2020; 26 (05) 488-491
- 3 Johnson P, Wong K, Chen Z. et al. Meta-analysis of intraprocedural comparative effectiveness of vascular plugs vs coils in proximal splenic artery embolization and associated patient radiation exposure. Curr Probl Diagn Radiol 2021; 50 (05) 623-628
- 4 Yu Q, Zangan S, Funaki B. Preliminary experience with a low-profile high-density braid occluder for transcatheter embolization of pulmonary arteriovenous malformations. J Vasc Interv Radiol 2024; 35 (01) 32-35.e2
- 5 Tan W. et al. Occlusion of aortopulmonary and venovenous collaterals prior to heart or combined heart-liver transplantation in Fontan patients: a single-center experience. Int J Cardiol Congenit Heart Dis 2021; 6: 100260
- 6 Lopera JE. The Amplatzer Vascular Plug: review of evolution and current applications. Semin Intervent Radiol 2015; 32 (04) 356-369
- 7 Wang W, Tam MD, Spain J, Quintini C. Gelfoam-assisted Amplatzer Vascular Plug technique for rapid occlusion in proximal splenic artery embolization. AJR Am J Roentgenol 2013; 200 (03) 677-681
- 8 Widlus DM, Moeslein FM, Richard III HM. Evaluation of the Amplatzer vascular plug for proximal splenic artery embolization. J Vasc Interv Radiol 2008; 19 (05) 652-656
- 9 Zhu X, Tam MD, Pierce G. et al. Utility of the Amplatzer Vascular Plug in splenic artery embolization: a comparison study with conventional coil technique. Cardiovasc Intervent Radiol 2011; 34 (03) 522-531
- 10 Tuite DJ, Kessel DO, Nicholson AA, Patel JV, McPherson SJ, Shaw DR. Initial clinical experience using the Amplatzer Vascular Plug. Cardiovasc Intervent Radiol 2007; 30 (04) 650-654
- 11 Wang W, Li H, Tam MD, Zhou D, Wang DX, Spain J. The Amplatzer Vascular Plug: a review of the device and its clinical applications. Cardiovasc Intervent Radiol 2012; 35 (04) 725-740
- 12 Jambon E, Hocquelet A, Petitpierre F. et al. Proximal embolization of splenic artery in acute trauma: comparison between Penumbra occlusion device versus coils or Amplatzer vascular plug. Diagn Interv Imaging 2018; 99 (12) 801-808
- 13 Schnüriger B, Inaba K, Konstantinidis A, Lustenberger T, Chan LS, Demetriades D. Outcomes of proximal versus distal splenic artery embolization after trauma: a systematic review and meta-analysis. J Trauma 2011; 70 (01) 252-260
- 14 Gunn AJ, Raborn JR, Griffin R, Stephens SW, Richman J, Jansen JO. A pilot randomized controlled trial of endovascular coils and vascular plugs for proximal splenic artery embolization in high-grade splenic trauma. Abdom Radiol (NY) 2021; 46 (06) 2823-2832
- 15 Kokabi N, Shuaib W, Xing M. et al. Intra-abdominal solid organ injuries: an enhanced management algorithm. Can Assoc Radiol J 2014; 65 (04) 301-309
- 16 Lin BC, Wu CH, Wong YC. et al. Comparison of outcomes of proximal versus distal and combined splenic artery embolization in the management of blunt splenic injury: a report of 202 cases from a single trauma center. Surg Endosc 2023; 37 (06) 4689-4697
- 17 Ahuja C, Farsad K, Chadha M. An overview of splenic embolization. AJR Am J Roentgenol 2015; 205 (04) 720-725
- 18 Bhatia A, Bryant EH, Fox B, Richardson A, Leichter J, Mohan P. Long-term effects of proximal splenic artery embolization on splenic volume and platelet count. Ann Vasc Surg 2023; 89: 166-173
- 19 Sammoud S, Ghelfi J, Barbois S, Beregi JP, Arvieux C, Frandon J. Preventive proximal splenic artery embolization for high-grade AAST-OIS adult spleen trauma without vascular anomaly on the initial CT scan: technical aspect, safety, and efficacy-an ancillary study. J Pers Med 2023; 13 (06) 889
- 20 Spittle A, Britcliffe A, Hamilton MJ. Splenic trauma in the Northern Territory; the impact of an interventional radiology service on splenic trauma management and outcomes. Heliyon 2023; 9 (06) e16993
- 21 Jamil H, Tariq W, Ameer MA. et al. Interventional radiology in low- and middle-income countries. Ann Med Surg (Lond) 2022; 77: 103594
- 22 Rong JJ, Liu D, Liang M. et al. The impacts of different embolization techniques on splenic artery embolization for blunt splenic injury: a systematic review and meta-analysis. Mil Med Res 2017; 4: 17
- 23 Ghosh A, Xiao N, Gordon AC, Funaki B, Lewandowski RJ. Embolic agents: vascular plugs. Semin Intervent Radiol 2022; 39 (05) 526-532