Abstract No. 515 Low-profile Braided Occluder for Transcatheter Embolization of Pulmonary Arteriovenous Malformation

The low-profile braided occluder (LOBO, Okami Medical, San Diego, CA) was designed to increase vascular occlusion efficacy by using wires less than 20 microns in diameter and increasing pore density. The present study aims to assess the safety, technical feasibility, and early efficacy of LOBO occluder for the treatment of pulmonary arteriovenous malformation (PAVM). A single-institution retrospective review was performed from April 2022 to May 2023, including a total of nine PAVM from four adult patients (3 female, 1 male, age range 33 months - 63 years) treated by LOBO (Table 515.1). Three patients tested genetically positive for HHT (75.0%). Under conscious sedation, LOBO occluders were deployed in the feeder artery as distally as possible but proximal to the PAVM sac. Two sizes of LOBO occluders were implemented, LOBO-3 and LOBO-5. Technical success was defined as angiographic stasis of the embolized feeder artery by the end of the procedure. Treatment success was defined as a decrease in the size of PAVM and/or draining vein diameter by 70% on post-embolization contrast-enhanced computed tomography. A total of 10 occluders were deployed in 10 vessels (median treated vessel diameters: 3 mm and 4 mm for LOBO-3 and LOBO-5 groups, respectively). All devices were successfully deployed into the feeder pulmonary arteries, achieving complete cessation of flow. There were no severe adverse events or device migration. Available short-term follow-up computed tomography (six PAVMs, median 7 months, range 1.5-7 months) demonstrated complete occlusion without persistence or recanalization. No evidence stroke, brain abscess, or hypoxia occurred during follow-up. LOBO occluders can be safely and effectively utilized for PAVM embolization, demonstrating a high technical success rate. Short-term imaging follow-up also indicates promising results in PAVM treatment success.