A catheter to curb your appetite?


A retrospective study reports that individuals who underwent embolization of the left gastric artery for gastrointestinal bleeding experienced a 7.9% decrease in body weight, three months after the procedure. Could embolization of the left gastric artery be used in the treatment of obesity?

In the retrospective investigation, conducted at Massachusetts General Hospital in Boston, researchers reviewed the records of patients who underwent transarterial embolization for upper gastrointestinal bleeding.

Senior researcher Rahmi Oklu, assistant professor of Radiology, Harvard Medical School, Boston, USA, told Interventional News: “The ghrelin literature is very exciting. Although it would be very convenient to have a single target hormone controlling appetite and satiety, there are probably many other undiscovered hormones, proteins and cell-signalling pathways that mediate food intake. When reading from basic science literature, I realised that ghrelin and probably many other unknown hormones were concentrated in the fundus of the stomach, the location of the left gastric artery distribution. Embolization of the left gastric artery is a routine procedure in interventional radiology. My resident, Andrew Gunn, and I began to look at our institution’s database to see whether patients who had their left gastric artery embolized lost weight. One important strength of this approach was that there would be no placebo effect, which is an important issue in prospective weight-control related studies.

“Of the 1,213 patients retrieved from our database, the majority were excluded for a variety of reasons such as embolization performed as part of cancer therapy or simply that weights were not recorded. We evaluated 19 patients in the left gastric artery embolization group and 28 patients in the matched control group. Our results showed that the embolized group demonstrated significant weight loss when compared to the control group. Embolic agents used primarily included coils as well as particles and gelfoam.

“We have teamed up with bariatric medicine at our institution to further investigate our retrospective observations in patients as well as at the molecular level in small and large animals.

“Given the significant morbidity and mortality of bariatric surgical interventions, a minimally invasive bariatric interventional approach could become an option, either as a stand-alone procedure or as a bridging therapy to surgery in extreme obesity cases.”

The researchers found that patients who underwent left gastric artery embolization lost an average of 7.9% of their body weight within three months of the procedure. Weight loss within the control group was 1.2% during the same time frame. The post-procedural weight loss of the experimental group was significantly greater than that observed in the control group (p=0.001).

Oklu also pointed out that left gastric artery embolization performed by an interventional radiologist is low risk when compared to more invasive weight loss interventions, such as gastric bypass and laparoscopic approaches. “The effect of left gastric artery embolization will need to be studied in larger populations and eventually in prospective trials,” he adds.

The results of the study were presented at the annual meeting of the Radiological Society of North America (RSNA) in December 2013.