Transradial left gastric artery embolization to treat severe obesity: A pilot study

Catheter Cardiovasc Interv. 2019 Feb 15;93(3):365-370. doi: 10.1002/ccd.27846. Epub 2018 Oct 4.

Abstract

Background: Bariatric surgery is currently the only effective treatment with long-lasting results to treat severe obesity.

Objectives: We performed a pilot study to evaluate the feasibility, safety and efficacy of percutaneous distal embolization of the left gastric artery (LGA) using a transradial approach.

Methods and results: We recruited seven severely obese male patients (mean age 48 ± 7 years) referred for diagnostic coronary angiography. Mean baseline weight was 160 ± 27 kg and body mass index was of 52 ± 8 kg/m2 . We successfully injected 300-500 μm polyvinyl alcohol particles using 5Fr catheters and all distal LGA were occluded at the end of procedures. Mean procedure duration was 24 ± 13 min and mean fluoroscopy time was 10 ± 5 min. Six patients reported mild transient epigastric discomfort, which resolved with proton pump inhibitors. At 2 months, the average weight loss was of 7 ± 6 kg (median loss: -10 kg [-2, -11]), 6 ± 12 kg (median loss: -9 kg [-16, +4]) at 6 months and 13 ± 17 kg (median loss: -11 kg [0, -25]) up to 12 months after index procedures.

Conclusion: Percutaneous transradial LGA embolization appears to be a promising technique to reduce the obesity burden. Randomized trials are required to further delineate the risk/benefit ratio, potential clinical indications and long term results.

Keywords: bariatrics; obesity; peripheral catheterization.

MeSH terms

  • Adult
  • Body Mass Index
  • Catheterization, Peripheral* / adverse effects
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Feasibility Studies
  • Gastric Artery* / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Obesity / diagnosis
  • Obesity / physiopathology
  • Obesity / therapy*
  • Particle Size
  • Pilot Projects
  • Polyvinyl Alcohol / administration & dosage*
  • Polyvinyl Alcohol / adverse effects
  • Punctures
  • Radial Artery* / diagnostic imaging
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome
  • Weight Loss*

Substances

  • Polyvinyl Alcohol