Top

CardioVascular and Interventional Radiology

Published in:

01-11-2018 | Review

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

Authors: Bin-Yan Zhong, Godwin Abiola, Clifford R. Weiss

Published in: CardioVascular and Interventional Radiology | Issue 11/2018

Abstract

Obesity is a worldwide public health epidemic that leads to increased morbidity, mortality, and cost burden to health care. Although bariatric surgery has been recognized as a standard invasive treatment for obesity, it is accompanied by relatively high morbidity and cost burden, as well as limited treatment outcome. Therefore, alternative treatments with lower morbidity and cost for surgery that target patients who are obese, but not morbidly obese, are needed. A minimally invasive trans-catheter procedure, named bariatric arterial embolization or bariatric embolization (BAE), has been identified as a potential solution, based on its safety and preliminary efficacy profiles. The purpose of this review is to introduce up-to-date clinical data and discuss future directions for BAE for the treatment of obesity.

Au N, Johnston DW. Too much of a good thing? Exploring the impact of wealth on weight. Health Econ. 2015;24(11):1403–21. https://doi.org/10.1002/hec.3094.CrossRefPubMed

Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003;289(1):76–9.CrossRef

Bays HE, Toth PP, Kris-Etherton PM, Abate N, Aronne LJ, Brown WV, et al. Obesity, adiposity, and dyslipidemia: a consensus statement from the National Lipid Association. J Clin Lipidol. 2013;7(4):304–83. https://doi.org/10.1016/j.jacl.2013.04.001.CrossRefPubMed

Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011;377(9765):557–67. https://doi.org/10.1016/s0140-6736(10)62037-5.CrossRefPubMedPubMedCentral

Cawley J, Meyerhoefer C. The medical care costs of obesity: an instrumental variables approach. J Health Econ. 2012;31(1):219–30. https://doi.org/10.1016/j.jhealeco.2011.10.003.CrossRefPubMed

Jones LR, Wilson CI, Wadden TA. Lifestyle modification in the treatment of obesity: an educational challenge and opportunity. Clin Pharmacol Ther. 2007;81(5):776–9. https://doi.org/10.1038/sj.clpt.6100155.CrossRefPubMed

Lowe MR. Self-regulation of energy intake in the prevention and treatment of obesity: is it feasible? Obes Res. 2003;11(Suppl):44S–59S. https://doi.org/10.1038/oby.2003.223.CrossRefPubMed

DeMaria EJ. Bariatric surgery for morbid obesity. The New England journal of medicine. 2007;356(21):2176–83. https://doi.org/10.1056/NEJMct067019.CrossRefPubMed

Jung Y. Role of Endoscopic Gastroplasty Techniques in the Management of Obesity. Clin Endosc. 2017;50(1):21–5. https://doi.org/10.5946/ce.2016.147.CrossRefPubMedPubMedCentral

10.

Vix M, Liu KH, Diana M, D’Urso A, Mutter D, Marescaux J. Impact of Roux-en-Y gastric bypass versus sleeve gastrectomy on vitamin D metabolism: short-term results from a prospective randomized clinical trial. Surg Endosc. 2014;28(3):821–6. https://doi.org/10.1007/s00464-013-3276-x.CrossRefPubMed

11.

Clinical Guidelines on the Identification. Evaluation, and treatment of overweight and obesity in adults-the evidence report. National Institutes of Health. Obesity research. 1998;6(Suppl 2):51S–209S.

12.

Montesi L, El Ghoch M, Brodosi L, Calugi S, Marchesini G, Dalle Grave R. Long-term weight loss maintenance for obesity: a multidisciplinary approach. Diabetes, Metab Syndr Obes Targets Ther. 2016;9:37–46. https://doi.org/10.2147/DMSO.S89836.CrossRef

13.

Wadden TA, Butryn ML, Byrne KJ. Efficacy of lifestyle modification for long-term weight control. Obes Res. 2004;12(Suppl):151S–62S. https://doi.org/10.1038/oby.2004.282.CrossRefPubMed

14.

NIH Conference. Gastrointestinal surgery for severe obesity. Consensus development conference panel. Ann Intern Med. 1991;115(12):956–61.CrossRef

15.

Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, et al. Bariatric surgery versus intensive medical therapy for diabetes–3-year outcomes. N Engl J Med. 2014;370(21):2002–13. https://doi.org/10.1056/NEJMoa1401329.CrossRefPubMedPubMedCentral

16.

Dumon KR, Murayama KM. Bariatric surgery outcomes. Surg Clin N Am. 2011;91(6):1313–38. https://doi.org/10.1016/j.suc.2011.08.014.CrossRefPubMed

17.

Encinosa WE, Bernard DM, Chen CC, Steiner CA. Healthcare utilization and outcomes after bariatric surgery. Med Care. 2006;44(8):706–12. https://doi.org/10.1097/01.mlr.0000220833.89050.ed.CrossRefPubMed

18.

Keating C, Neovius M, Sjoholm K, Peltonen M, Narbro K, Eriksson JK, et al. Health-care costs over 15 years after bariatric surgery for patients with different baseline glucose status: results from the Swedish Obese Subjects study. Lancet Diabet Endocrinol. 2015;3(11):855–65. https://doi.org/10.1016/S2213-8587(15)00290-9.CrossRef

19.

Weiner JP, Goodwin SM, Chang HY, Bolen SD, Richards TM, Johns RA, et al. Impact of bariatric surgery on health care costs of obese persons: a 6-year follow-up of surgical and comparison cohorts using health plan data. JAMA Surg. 2013;148(6):555–62. https://doi.org/10.1001/jamasurg.2013.1504.CrossRefPubMed

20.

Srivastava G, Apovian CM. Current pharmacotherapy for obesity. Nat Rev Endocrinol. 2017. https://doi.org/10.1038/nrendo.2017.122.CrossRefPubMed

21.

Apovian CM, Aronne LJ, Bessesen DH, McDonnell ME, Murad MH, Pagotto U, et al. Pharmacological management of obesity: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2015;100(2):342–62. https://doi.org/10.1210/jc.2014-3415.CrossRefPubMed

22.

Maahs D, de Serna DG, Kolotkin RL, Ralston S, Sandate J, Qualls C, et al. Randomized, double-blind, placebo-controlled trial of orlistat for weight loss in adolescents. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2006;12(1):18–28. https://doi.org/10.4158/EP.12.1.18.CrossRef

23.

Smith SR, Weissman NJ, Anderson CM, Sanchez M, Chuang E, Stubbe S, et al. Multicenter, placebo-controlled trial of lorcaserin for weight management. New Engl J Med. 2010;363(3):245–56. https://doi.org/10.1056/NEJMoa0909809.CrossRefPubMed

24.

Gadde KM, Allison DB, Ryan DH, Peterson CA, Troupin B, Schwiers ML, et al. Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial. Lancet. 2011;377(9774):1341–52. https://doi.org/10.1016/S0140-6736(11)60205-5.CrossRefPubMed

25.

Cummings DE, Weigle DS, Frayo RS, Breen PA, Ma MK, Dellinger EP, et al. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med. 2002;346(21):1623–30. https://doi.org/10.1056/NEJMoa012908.CrossRefPubMed

26.

Verdam FJ, Schouten R, Greve JW, Koek GH, Bouvy ND. An update on less invasive and endoscopic techniques mimicking the effect of bariatric surgery. J Obes. 2012;2012:597871. https://doi.org/10.1155/2012/597871.CrossRefPubMedPubMedCentral

27.

Abu Dayyeh BK, Edmundowicz S, Thompson CC. Clinical practice update: expert review on endoscopic bariatric therapies. Gastroenterology. 2017;152(4):716–29. https://doi.org/10.1053/j.gastro.2017.01.035.CrossRefPubMed

28.

Neylan CJ, Dempsey DT, Tewksbury CM, Williams NN, Dumon KR. Endoscopic treatments of obesity: a comprehensive review. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2016;12(5):1108–15. https://doi.org/10.1016/j.soard.2016.02.006.CrossRef

29.

Kumar N, Thompson CC. Endoscopic solutions for weight loss. Curr Opin Gastroenterol. 2011;27(5):407–11. https://doi.org/10.1097/MOG.0b013e328349e240.CrossRefPubMed

30.

Wren AM, Bloom SR. Gut hormones and appetite control. Gastroenterology. 2007;132(6):2116–30. https://doi.org/10.1053/j.gastro.2007.03.048.CrossRefPubMed

31.

Venieratos D, Panagouli E, Lolis E, Tsaraklis A, Skandalakis P. A morphometric study of the celiac trunk and review of the literature. Clin Anat. 2013;26(6):741–50. https://doi.org/10.1002/ca.22136.CrossRefPubMed

32.

Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K. Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature. 1999;402(6762):656–60. https://doi.org/10.1038/45230.CrossRefPubMed

33.

Cummings DE, Overduin J. Gastrointestinal regulation of food intake. J Clin Investig. 2007;117(1):13–23. https://doi.org/10.1172/JCI30227.CrossRefPubMed

34.

Cummings DE, Purnell JQ, Frayo RS, Schmidova K, Wisse BE, Weigle DS. A preprandial rise in plasma ghrelin levels suggests a role in meal initiation in humans. Diabetes. 2001;50(8):1714–9.CrossRef

35.

English PJ, Ghatei MA, Malik IA, Bloom SR, Wilding JP. Food fails to suppress ghrelin levels in obese humans. J Clin Endocrinol Metab. 2002;87(6):2984. https://doi.org/10.1210/jcem.87.6.8738.CrossRefPubMed

36.

Ravussin Y, Leibel RL, Ferrante AW Jr. A missing link in body weight homeostasis: the catabolic signal of the overfed state. Cell Metab. 2014;20(4):565–72. https://doi.org/10.1016/j.cmet.2014.09.002.CrossRefPubMedPubMedCentral

37.

Arepally A, Barnett BP, Montgomery E, Patel TH. Catheter-directed gastric artery chemical embolization for modulation of systemic ghrelin levels in a porcine model: initial experience. Radiology. 2007;244(1):138–43. https://doi.org/10.1148/radiol.2441060790.CrossRefPubMed

38.

Arepally A, Barnett BP, Patel TH, Howland V, Boston RC, Kraitchman DL, et al. Catheter-directed gastric artery chemical embolization suppresses systemic ghrelin levels in porcine model. Radiology. 2008;249(1):127–33. https://doi.org/10.1148/radiol.2491071232.CrossRefPubMedPubMedCentral

39.

Bawudun D, Xing Y, Liu WY, Huang YJ, Ren WX, Ma M, et al. Ghrelin suppression and fat loss after left gastric artery embolization in canine model. Cardiovasc Intervent Radiol. 2012;35(6):1460–6. https://doi.org/10.1007/s00270-012-0362-8.CrossRefPubMed

40.

Paxton BE, Kim CY, Alley CL, Crow JH, Balmadrid B, Keith CG, et al. Bariatric embolization for suppression of the hunger hormone ghrelin in a porcine model. Radiology. 2013;266(2):471–9. https://doi.org/10.1148/radiol.12120242.CrossRefPubMed

41.

Paxton BE, Alley CL, Crow JH, Burchette J, Weiss CR, Kraitchman DL, et al. Histopathologic and immunohistochemical sequelae of bariatric embolization in a porcine model. J Vasc Interv Radiol. 2014;25(3):455–61. https://doi.org/10.1016/j.jvir.2013.09.016.CrossRefPubMedPubMedCentral

42.

Paxton BE, Arepally A, Alley CL, Kim CY. Bariatric embolization: pilot study on the impact of gastroprotective agents and arterial distribution on ulceration risk and efficacy in a porcine model. J Vasc Interv Radiol. 2016;27(12):1923–8. https://doi.org/10.1016/j.jvir.2016.07.021.CrossRefPubMed

43.

Kim JM, Kim MD, Han K, Muqmiroh L, Kim SU, Kim GM, et al. Bariatric arterial embolization with non-spherical polyvinyl alcohol particles for ghrelin suppression in a swine model. Cardiovasc Intervent Radiol. 2017;40(5):744–9. https://doi.org/10.1007/s00270-017-1600-x.CrossRefPubMed

44.

Pasciak AS, Bourgeois AC, Paxton BE, Nodit L, Coan PN, Kraitchman D, et al. Bariatric radioembolization: a pilot study on technical feasibility and safety in a porcine model. J Vasc Interv Radiol. 2016;27(10):1509–17. https://doi.org/10.1016/j.jvir.2016.05.020.CrossRefPubMed

45.

Diana M, Pop R, Beaujeux R, Dallemagne B, Halvax P, Schlagowski I, et al. Embolization of arterial gastric supply in obesity (EMBARGO): an endovascular approach in the management of morbid obesity. proof of the concept in the porcine model. Obes Surg. 2015;25(3):550–8. https://doi.org/10.1007/s11695-014-1535-0.CrossRefPubMed

46.

Gunn AJ, Oklu R. A preliminary observation of weight loss following left gastric artery embolization in humans. J Obes. 2014;2014:185349. https://doi.org/10.1155/2014/185349.CrossRefPubMedPubMedCentral

47.

Anton K, Rahman T, Bhanushali A, Nadal L, Pierce G, Patel A. Weight loss following left gastric artery embolization in a human population without malignancy: a retrospective review. J Obes Weight Loss Ther 2015;5(6):1–4. https://doi.org/10.4172/2165-7904.1000285 CrossRef

48.

Kipshidze N, Archvadze A, Bertog S, Leon MB, Sievert H. Endovascular Bariatrics: first in Humans Study of Gastric Artery Embolization for Weight Loss. JACC Cardiovasc Interv. 2015;8(12):1641–4. https://doi.org/10.1016/j.jcin.2015.07.016.CrossRefPubMed

49.

Syed MI, Morar K, Shaikh A, Craig P, Khan O, Patel S, et al. Gastric artery embolization trial for the lessening of appetite nonsurgically (GET LEAN): six-month preliminary data. Journal of vascular and interventional radiology: JVIR. 2016;27(10):1502–8. https://doi.org/10.1016/j.jvir.2016.07.010.CrossRefPubMed

50.

Weiss CR, Akinwande O, Paudel K, Cheskin LJ, Holly B, Hong K, et al. Clinical safety of bariatric arterial embolization: preliminary results of the BEAT obesity trial. Radiology. 2017;283(2):598–608. https://doi.org/10.1148/radiol.2016160914.CrossRefPubMedPubMedCentral

51.

Bai ZB, Qin YL, Deng G, Zhao GF, Zhong BY, Teng GJ. Bariatric embolization of the left gastric arteries for the treatment of obesity: 9-month data in 5 patients. Obes Surg. 2018;28(4):907–15. https://doi.org/10.1007/s11695-017-2979-9.CrossRefPubMed

52.

Bayham BE, Bellanger DE, Hargroder AG, Johnson WD, Greenway FL. Racial differences in weight loss, payment method, and complications following Roux-en-Y gastric bypass and sleeve gastrectomy. Adv Ther. 2012;29(11):970–8. https://doi.org/10.1007/s12325-012-0062-4.CrossRefPubMed

53.

Shoar S, Saber AA, Aladdin M, Bashah MM, AlKuwari MJ, Rizwan M, et al. Bariatric manipulation of gastric arteries: a systematic review on the potential concept for treatment of obesity. Int Jo Surg. 2016;36(Pt A):177–82. https://doi.org/10.1016/j.ijsu.2016.10.014.CrossRef

54.

Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37. https://doi.org/10.1001/jama.292.14.1724.CrossRefPubMed

Title: Bariatric Arterial Embolization for Obesity: A Review of Early Clinical Evidence
Authors: Bin-Yan Zhong
Godwin Abiola
Clifford R. Weiss
Publication date: 01-11-2018
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 11/2018
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-018-1996-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 11/2018

Comments to “Usefulness of Hydrogel-Coated Coils in Embolization of Pulmonary Arteriovenous Malformations”

Immediate Clinical Success After Percutaneous Ablation of Extra-adrenal Paraganglioma

Evaluation of the Heat Sink Effect After Transarterial Embolization When Performed in Combination with Thermal Ablation of the Liver in a Rabbit Model

Hydrophilic Stent Coating Inhibits Platelet Adhesion on Stent Surfaces: Initial Results In Vitro

Thrombophilia Associated with Early Post-angioplasty Thrombosis of Dialysis Vascular Access

Y-90 Radioembolization Combined with a PD-1 Inhibitor for Advanced Hepatocellular Carcinoma