Comparative Analysis of the LOBO Device and Coils for Proximal Splenic Artery Embolization: A Multi-Institutional Retrospective Study

PURPOSE: To evaluate the technical and clinical efficacy of the low-profile braided occluder (LOBO) device for proximal splenic artery embolization (SAE) and compare its performance with conventional coil embolization. MATERIALS AND METHODS: This retrospective multi-institutional study included 44 consecutive patients who underwent proximal SAE between June 2023 and October 2025. Demographic data, etiology, embolic device type, fluoroscopy time, radiation dose, and outcomes were recorded. Technical success was defined as complete angiographic occlusion using the index device. Clinical success was defined as the absence of rebleeding or reintervention within 30 days. RESULTS: Of the 44 patients (mean age, 43.2 years; 39% females), 22 were treated using the LOBO device and 22 with coils. Trauma was the most common etiology (n = 37, 84.1%). There were no clinical or demographic characteristic differences between the LOBO and coil groups. Proximal SAE was achieved with a single LOBO device in all patients. The mean number of coils used was 4.6 per case (median 3.5), p < 0.001. Median fluoroscopy time was significantly reduced with LOBO compared with coils (11.65 vs 18.9 min; p = 0.01). Radiation dose was significantly lower as well in the LOBO group compared with the coil group (128.4 vs 198.5 mGy; p = 0.04). Clinical success was not significantly different between the groups, with the LOBO group achieving 100% and the coil group 90.9% (p > 0.05). Splenic infarction was significantly higher with coils than with LOBO (33.3% vs 22.7%; p = 0.046). No major adverse events occurred, and minor events were self-limited. One death in each group was attributable to polytrauma and unrelated to the procedure. CONCLUSION: The LOBO device provides safe, effective proximal SAE with significantly reduced fluoroscopy time and radiation dose compared with coils. Larger prospective studies are warranted. LEVEL OF EVIDENCE: Level 4, study (retrospective, standard quality).