Bariatric Embolization in the Treatment of Patients with a Body Mass Index Between 30 and 39.9 kg/m2 (Obesity Class I and II) and Metabolic Syndrome, a Pilot Study

• Published in: Cardiovascular and interventional radiology Vol. 44; no. 4; pp. 598 - 606
• Main Authors: Levigard, Raphael Braz, Serrão, Henrique, Castro, Camille, Matos, Priscila, Mattos, Fernanda, Madeira, Eduardo, Rosseti, Camila Lüdke, de Carvalho, Denise Pires, Dantas, Joana Rodrigues, Zajdenverg, Lenita, Madeira, Miguel
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.04.2021; Springer Nature B.V
• Subjects: Arteries; Binge eating; Body mass; Body mass index; Body size; Body weight; Cardiology; Clinical Investigation; Complications; Eating disorders; Embolisation (arterial); Embolization; Endoscopy; Ghrelin; Imaging; Insulin; Insulin resistance; Medicine; Medicine & Public Health; Metabolic disorders; Metabolic syndrome; Nuclear Medicine; Obesity; Patients; Quality of life; Radiology; Safety; Thrombosis; Ulcers; Ultrasound; Veins & arteries; Weight reduction; Obesity; Binge eating; Ghrelin; Insulin resistance; Metabolic syndrome; Bariatric embolization; Quality of life
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-021-02776-7

Introduction To evaluate the efficacy and clinical safety of bariatric arterial embolization (BAE) in adults with body mass index (BMI) between 30 and 39.9 kg/m 2 and metabolic syndrome (MS). Materials and methods Between March and August 2018, ten female participants between 21 and 48-years-old, median BMI of 36.37 ± 2.58 kg/m 2 and MS were enrolled in this prospective trial. We embolized the fundal branches from the left gastric and other artery sources, which resulted in embolization of at least two arteries in 9 out 10 participants. Six months after bariatric embolization, efficacy was assessed by changes in total body weight (TBW), ghrelin and Homeostatic Model Assessment—Insulin Resistance (HOMA-IR) levels and by changes in quality of life (QOL) and in binge eating scale (BES) scores. Safety was assessed by the identification of any related complications, including gastric ulcers, screened by gastrointestinal endoscopy, performed before and one week and one month after BAE. Results Six months after embolization, TBW decreased by 6.8% (6.22 kg ± 3.6; p  = .01), serum ghrelin dropped from 25.39 pg/ml ± 10.63 to 17.1 ± 8.07 ( p  = 0.01), and HOMA-IR decreased from 7.29 ± 5.66 to 3.73 ± 1.99 ( p  = 0.01). The QOL scores improved from 59.64 ± 5.59 to 69.02 ± 11.97 ( p  < 0.05) and in the BES from 21.50 ± 8.89 to 9.60 ± 4.40 ( p  = 0.01). Endoscopy revealed symptomatic gastric ulcers in two participants, which had healed without sequelae. In one participant, ultrasound revealed an asymptomatic focal arterial thrombus at the left distal radial artery puncture site. Conclusion BAE is effective in reducing weight, insulin resistance and ghrelin levels and improving BES and QOL scores in patients with class I and II obesity and MS, with no major complications.