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Obesity Surgery
Published in: Obesity Surgery 4/2018

01-04-2018 | Original Contributions

Bariatric Embolization of the Left Gastric Arteries for the Treatment of Obesity: 9-Month Data in 5 Patients

Authors: Zhi-Bin Bai, Yong-Lin Qin, Gang Deng, Guo-Feng Zhao, Bin-Yan Zhong, Gao-Jun Teng

Published in: Obesity Surgery | Issue 4/2018

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Abstract

Purpose

The purpose of this study is to investigate the safety and 9-month effectiveness of transcatheter left gastric artery embolization (LGAE) for treating patients with obesity.

Materials and Methods

The protocol of this study was approved by the Institutional Ethics Review Board. Five obese patients (3 men and 2 women) with mean weight of 102.0 ± 16.19 kg (range, 82.1–125.5 kg) and mean body mass index (BMI) of 38.1 kg/m2 ± 3.8 (range, 32.9–42.4 kg/m2) underwent LGAE with polyvinyl alcohol (PVA) particles in diameter of 500–710 μm. The primary endpoint was the safety by grading the adverse events (AEs) according to the Common Terminology Criteria for Adverse Events (CTCAE v4.0) within 30 days after LGAE. The secondary endpoints were measured with serum ghrelin and leptin levels, body weight, waist circumference, waist-to-height ratio, and abdominal fat quantity on MRI at the day immediately before LGAE and every 3 months after LGAE.

Results

LGAE was successfully performed in all patients. A superficial linear ulceration below the cardia was seen in 1 patient 3 days after LGAE and healed within 30 days. No other serious AEs (grade III or above) occurred. Average body weight loss at 3, 6, and 9 months was 8.28 ± 7.3 kg (p = 0.074), 10.42 ± 8.21 kg (p = 0.047), and 12.9 ± 14.66 kg (p = 0.121), respectively. The level of serum ghrelin decreased by 40.83% (p = 0.009), 31.94% (p = 0.107), and 24.82% (p = 0.151) at 3, 6, and 9 months after LGAE, respectively. There was minimal reduction of leptin levels at 3 and 6 months following LGAE (decreased by 0.26%, p = 0.929, and 4.33%, p = 0.427, respectively), but it declined obviously 9 months after LGAE (decreased by 11.22%, p = 0.295).
Both waist circumference and waist-to-height ratio decreased after LGAE. MRI showed the area of subcutaneous adipose tissue decreased from the baseline of 400.90 ± 79.25 to 320.36 ± 68.06 cm2 (decreased by 20.09%, p = 0.006) at 3 months, to 328.31 ± 52.67 cm2 (decreased by 18.11%, p = 0.020) at 6 months, and to 286.40 ± 55.72 cm2 (decreased by 28.52%, p = 0.101) at 9 months after LGAE, respectively. But the decrease of abdominal fat loss at 9 months after LGAE was largely due to the reduction in visceral adipose tissue.

Conclusions

Our study with 9-month data in 5 patients indicates that bariatric embolization of the LGA is a safe and may be a promising strategy to suppress the production of ghrelin and results in weight loss and abdominal fat reduction.

Trial Registration

ClinicalTrials.​gov (NCT02786108).
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Metadata
Title
Bariatric Embolization of the Left Gastric Arteries for the Treatment of Obesity: 9-Month Data in 5 Patients
Authors
Zhi-Bin Bai
Yong-Lin Qin
Gang Deng
Guo-Feng Zhao
Bin-Yan Zhong
Gao-Jun Teng
Publication date
01-04-2018
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2979-9

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