Transcatheter bariatric embolotherapy (TBE) of the left gastric artery is a safe and effective method for Weight loss in obese patientsAccording to study results published in the Journal of the American College of Cardiology.
Previous studies suggested that TBE of the left gastric artery may aid patients’ weight loss efforts by reducing ghrelin, an appetite-stimulating hormone secreted from the fundus of the stomach. The current study aimed to determine the safety and effectiveness of TBE for weight loss.
The single-blind study included patients with obesity (body mass index, 35-55 kg / m2). Participants were randomized to either sham (control) or TBE of the left gastric artery using an occlusion balloon microcatheter to receive 300 to 500 µg. m to administer embolic beads (intervention group). The primary result was total body weight loss after 6 months.
The sample consisted of 44 patients (mean age 45.5 years; 36 women). After 4 participants had revoked their consent during the baseline visit, 20 subjects were assigned to the bariatric transcatheter embolization and 20 subjects to the sham control.
After 6 months, the mean absolute and percentage weight loss in the intention-to-treat analysis was significantly higher in the participants in the intervention group compared to the control group (7.4 kg versus 3.0 kg, P = 0.034 and 6.4% versus 2.8)%, P = 0.052).
In a similar way, the mean absolute and percentage weight loss in the per-protocol analysis after TBE was significantly higher (9.4 kg versus 1.9 kg, P = 0.0002 and 8.3% versus 1.8%, respectively, P = 0.0011). A total of 60% of the TBE patients achieved a total body weight loss of 5% or more compared to 12.5% of the patients in the control group (P = 0.009).
After 12 months, the absolute and percent weight loss in the treatment intentions (7.8 kg and 6.5%) and in the protocol-related analyzes (9.3 kg and 9.3%) were maintained.
Ghrelin levels decreased in the intervention group after 6 and 12 months (12.2% and 15.5%, respectively). In addition, the time to reach fullness was 1.7 minutes shorter on average for the TBE group.
The most common post-procedure adverse events were mild and included nausea and vomiting (7 cases each) and stomach pain (4 cases). In the control group, nausea (4 cases) and stomach pain (3 cases) were reported.
TBE endoscopy revealed 5 cases of asymptomatic ulcers. There was only 1 serious adverse event in the study and it was considered unrelated to the intervention.
The study had several limitations, including the lack of a control group at 6 months, no data on the impact of weight loss on cardiovascular outcomes, and data collection from only 2 centers in Europe.
“These data suggest that embolotherapy could play an important role in mitigating this global health epidemic if it is confirmed to be safe and effective in larger future studies,” the researchers write.
Disclosure: This clinical study was supported by Endobar Solutions. For a full list of the authors’ information, see the original reference.
reference
Reddy VY, Neužil P., Musikantow D. et al. Transcatheter bariatric embolotherapy for weight loss in obesity. J Am Coll Cardiol. 2020; 76 (20): 2305-2. 2317. doi: 10.1016 / j.jacc.2020.09.550
