SIR 2023: Bariatric arterial embolization associated with “significant” muscle-sparing weight loss


Lead researchers Clifford Weiss and Daniel Giraldo Herrera (Johns Hopkins University School of Medicine, Baltimore, USA) presented their recent bariatric arterial embolization (BAE) study at the Society of Interventional Radiology (SIR) annual scientific meeting (4–9 March, Phoenix, USA). Their research found that the procedure was associated with “significant” weight loss that did not affect muscle mass, as detected by whole-body magnetic resonance imaging anthropometry.

The authors note in the study abstract that the purpose of their research was “to evaluate the early effects of BAE on multicompartment fat and muscle body composition”, which constitutes the pilot phase of the BEATLES trial (bariatric embolization of arteries with imaging visible embolics).

BEATLES is a US Food and Drug Administration (FDA)-approved, physician-initiated investigational device exemption (IDE) study that, Weiss, Herrera, et al stipulate in their abstract, “evaluates tightly calibrated 100–200μm radiopaque microspheres” (BT-001933-01, Boston Scientific) delivered transarterially into the gastric fundus, supplied by the left gastric and left gastroepiploic arteries. Adult participants with obesity—defined as those with a body mass index [BMI]≥35 kg/m2—were scanned at zero (baseline), three, and six months post-BAE from neck to knee using a Siemens Skyra 3T magnetic resonance imaging (MRI) scanner. The researched employed a dual-echo Dixon water-fat vibe protocol, and a single-slice multiecho Dixon proton liver density acquisition.

Anthropometrics were gathered using AMRA Researcher (AMRA Medical), a semi-automated cloud-based MRI segmentation tool, and statistical testing was performed via repeated measures correlation (Rrm).

Regarding the results, the researchers shared in their write-up that seven patients (six female, one male) with a mean age of 39.6 ± 11.0 years and Centers for Disease Control and Prevention-defined class II–III obesity underwent BAE. At zero, three, and six months, mean body weight was 125.9±24.4, 113.5±21.2, and 110.7±23.3kg (R rm=-0.694 [95% confidence interval (CI) -0.921–-0.113], P value=0.012). Weight-to-thigh muscle volume ratios were 10.3±1.9, 10.0±0.5, and 9.2±1.3 kg/L (Rrm =0.89 [95% CI 0.64–0.97], P value =0.001), respectively.

Weiss, Herrera, et al were able to conclude that “BAE using 100–200μm microspheres is associated with significant postprocedural muscle-sparing weight loss via subcutaneous and intramuscular fat reduction.”



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