PMID- 29063494 OWN - NLM STAT- MEDLINE DCOM- 20181120 LR - 20181120 IS - 1708-0428 (Electronic) IS - 0960-8923 (Linking) VI - 28 IP - 4 DP - 2018 Apr TI - Bariatric Embolization of the Left Gastric Arteries for the Treatment of Obesity: 9-Month Data in 5 Patients. PG - 907-915 LID - 10.1007/s11695-017-2979-9 [doi] AB - 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/m(2) +/- 3.8 (range, 32.9-42.4 kg/m(2)) underwent LGAE with polyvinyl alcohol (PVA) particles in diameter of 500-710 mum. 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 cm(2) (decreased by 20.09%, p = 0.006) at 3 months, to 328.31 +/- 52.67 cm(2) (decreased by 18.11%, p = 0.020) at 6 months, and to 286.40 +/- 55.72 cm(2) (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). FAU - Bai, Zhi-Bin AU - Bai ZB AD - Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhong-Da Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China. FAU - Qin, Yong-Lin AU - Qin YL AD - Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhong-Da Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China. FAU - Deng, Gang AU - Deng G AD - Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhong-Da Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China. FAU - Zhao, Guo-Feng AU - Zhao GF AD - Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhong-Da Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China. FAU - Zhong, Bin-Yan AU - Zhong BY AD - Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhong-Da Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China. FAU - Teng, Gao-Jun AU - Teng GJ AUID- ORCID: 0000-0003-1145-0798 AD - Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhong-Da Hospital, Medical School, Southeast University, 87 Dingjiaqiao Road, Nanjing, 210009, China. gjteng@vip.sina.com. LA - eng SI - ClinicalTrials.gov/NCT02786108 GR - BL2013029/Jiangsu Provincial Special Program of Medical Science ,China/International GR - 2013CB733800, 2013733803/National Basic Research Program of China/International GR - 81230034, 81520108015/National Natural Science Foundation of China/International PT - Clinical Trial PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - Obes Surg JT - Obesity surgery JID - 9106714 RN - 0 (Ghrelin) RN - 0 (Leptin) SB - IM CIN - Obes Surg. 2018 Nov;28(11):3623-3624. PMID: 30043145 CIN - Obes Surg. 2018 Nov;28(11):3627-3628. PMID: 30128644 CIN - Obes Surg. 2018 Nov;28(11):3625-3626. PMID: 30182335 CIN - Obes Surg. 2019 Jun;29(6):1939-1941. PMID: 30877443 MH - Adult MH - Arteries/pathology/*surgery MH - Bariatric Surgery/*methods MH - Body Mass Index MH - Embolization, Therapeutic/*methods MH - Female MH - Ghrelin/blood MH - Humans MH - Leptin/blood MH - Male MH - Middle Aged MH - Obesity, Morbid/blood/*therapy MH - Stomach/*blood supply/pathology/surgery MH - Waist Circumference MH - Weight Loss MH - Young Adult OTO - NOTNLM OT - Bariatric embolization OT - Ghrelin OT - Left gastric artery OT - Obesity OT - Weight loss EDAT- 2017/10/25 06:00 MHDA- 2018/11/21 06:00 CRDT- 2017/10/25 06:00 PHST- 2017/10/25 06:00 [pubmed] PHST- 2018/11/21 06:00 [medline] PHST- 2017/10/25 06:00 [entrez] AID - 10.1007/s11695-017-2979-9 [pii] AID - 10.1007/s11695-017-2979-9 [doi] PST - ppublish SO - Obes Surg. 2018 Apr;28(4):907-915. doi: 10.1007/s11695-017-2979-9.