Bariatric Arterial Embolization for Obesity: A Review of Early Clinical Evidence

Percutaneous gastric embolization for obesity: A prospective mid-term outcomes study

INTRODUCTION

Obesity represents one of the most pressing public health challenges that needs to be solved globally, with serious health implications. Despite primary prevention efforts the prevalence of obesity continues to increase. Percutaneous gastric embolisation (PGE) has emerged as a promising technique in the management of this disease.

MATERIAL AND METHODS

Prospective longitudinal cohort study including 15 patients diagnosed with grade III obesity, admitted to the Haemodynamics Service of the Cardiovascular Health Institute during the year 2022.

RESULTS

The 86.7% of the PGEs were successful. Treated patients experienced significant weight loss when comparing baseline weight (101.2±23.0, SE=5.9) with weight at 6 months after the interventional procedure (91.5±19.8, SE=5.1) t(14)=5.3, P<.001, d=0.45, especially males (106.7±18.4, P=.01). No major vascular complications, gastric ulcer or ischaemia, or abdominal symptoms were documented in any of the patients included in the study. Only 6 patients (40%) presented with epigastralgia, 9 (60%) with nausea and 3 (20%) with vomiting.

CONCLUSIONS

Percutaneous gastric embolisation is an effective and safe procedure to reduce BMI with a high success rate, well tolerated by obese patients, without major complications, whose results are maintained over time.

Bariatric Artery Embolization for Obese Patients. An Up-to-Date Review

Overweight and obesity are one of public health's major problems in the world. Conservative treatment with exercise, diet and pharmacotherapy is often ineffective, especially in the long term. Bariatric surgery is the gold standard method for a sustained long-term weight loss. Recently the endovascular technique of bariatric artery embolization (BAE) has been studied as an obesity and overweight treatment, with promising results. The goal of this article is to analyze the rationale behind BAE and to provide an up-to-date analysis of its strengths and limitation in comparison with bariatric surgery as a treatment for obesity.

Comparison of Soluble Gelatin Sponge Particles and Tris-acryl Gelatin Microspheres for Bariatric Arterial Embolization in Swine

The purpose of this study was to compare complications and the number of ghrelin-expressing cells (GECs) after bariatric arterial embolization (BAE) using soluble gelatin sponge particles (SGSs) or tris-acryl gelatin microspheres (MSs) in swine. Twelve swine underwent embolization of gastric fundal arteries with SGSs (n = 4) or MSs (n = 4) or underwent saline infusion (n = 4, control group). One week later, the number of gastric ulcers and the percentage of GECs were compared among the 3 groups. There were no ulcers in the SGS and control groups. Two swine in the MS group had 4 large ulcers (12-50 mm in size). The mean percentages of GECs were significantly lower in the SGS (2.7% ± 0.9%) and MS (2.5% ± 1.0%) groups compared with the control group (3.7% ± 1.3%; P = .038 and P = .016, respectively). SGSs may be safer than MSs for BAE while inducing a similar reduction of GECs in swine.

Weight Loss and Gastrointestinal Hormone Variation Caused by Gastric Artery Embolization: An Updated Analysis Study

OBJECTIVE

Many gastric artery embolizations (GAE) have been performed in recent years. We try to determine whether GAE caused weight loss by decreasing gastrointestinal hormone through the analysis of weight loss and gastrointestinal hormones changes.

METHODS

The PubMed and Medline databases, and the Cochrane Library, were searched using the following keywords. A total of 10 animal trials (n=144), 15 human trials (n=270) were included for analysis. After GAE, we mainly evaluated the changes in body weight loss (BWL) and body mass index (BMI), as well as metabolic indexes, such as blood glucose, lipids, and gastrointestinal hormones levels.

RESULTS

Animal subjects received either chemical or particle embolization, while human subjects only received particle embolization. In animal trials (growing period), the GAE group gained weight significantly slower than the sham-operated group, ghrelin levels decreased. In human trials, GAE brought more weight loss in the early stages, with a trend towards weight recovery after several months that was still lower than baseline levels. Besides weight loss, abnormal metabolic indicators, such as blood glucose and lipids were modified, and the quality of life (QOL) scores of obese patients improved. In addition, weight loss positively correlates with ghrelin.

CONCLUSION

GAE may help people lose weight and become a new minimally invasive and effective surgery for the treatment of modest obesity. Physiologic changes in gastrointestinal tract of gastrointestinal hormones level may be one reason for weight loss in GAE.

Future of IR: Emerging Techniques, Looking to the Future…and Learning from the Past

Innovation has been the cornerstone of interventional radiology since the early years of the founders, with a multitude of new therapeutic approaches developed over the last 50 years. What is the future holding for us? This article presents an overview of the in-coming developments that are catching on at this moment, particularly focusing on three items: the new applications of existing techniques, particularly embolotherapy and interventional oncology; the cutting-edge devices; the imaging technologies at the forefront of the image-guidance. Besides this, clinical vision and patient relation remain crucial for the future of the discipline.