Efficient Endovascular Treatment Using LOBO for Aneurysm Sacrifice

Introduction/Purpose Parent vessel sacrifice is a recognized treatment strategy for complex posterior circulation aneurysms. This report describes the novel intracranial use of a low‐profile braided occluder (LOBO ® ) device to achieve endovascular vessel sacrifice in conjunction with flow diversion, providing rapid and efficient occlusion to facilitate aneurysm embolization in the vertebrobasilar system. Materials/Methods A 61‐year‐old male with unruptured, symptomatic fusiform basilar artery aneurysm underwent endovascular treatment. Flow diversion stents were placed from the right vertebral artery to the left posterior cerebral artery. Sacrifice of the distal left vertebral artery was performed using a single LOBO ® device deployed distal to the posterior inferior cerebellar artery origin. The procedure involved bilateral radial access, sequential stent deployment, and targeted vessel occlusion. Post‐procedure vessel imaging was used to confirm device placement and occlusion (Figure 1). Results The endovascular technique successfully achieved complete occlusion of the distal left vertebral artery and stabilized the aneurysm without procedural complications. No thromboembolic events or parent vessel occlusion were noted. The patient tolerated the intervention well with improvement in presenting symptoms and remained clinically stable at early follow‐up. Rapid occlusion of the vessel was confirmed via angiography and post‐procedural magnetic resonance angiography. Conclusion This technical case demonstrates that the LOBO ® braided occluder may be a safe and efficient option for parent vessel sacrifice within the intracranial circulation, offering practical advantages over alternative devices. To the authors’ knowledge, this is the first reported intracranial use of this device. Expanded research and procedural experience are needed to fully define its role in neurovascular interventions. Graphics/Tables: Figure 1. Multimodal procedural imaging: A) CTA of fusiform basilar aneurysm, B‐D) Angiography showing stent deployment, E‐G) LOBO ® device placement and occlusion, H) Post‐deployment confirmation of complete vessel sacrifice.