USA: A new, minimally invasive procedure called bariatric embolization holds promise to help obese people lose weight and reduce appetite for up to one year, according to new evidence from a study published in the journal Radiology. The procedure involves threading a cannula through an artery in the wrist or going to the stomach. Then, microscopic beads are injected through the tube to partially block the artery that supplies blood to the stomach that is enough to suppress production of hunger-stimulating hormones but not enough to cause tissue damage.
Findings from the Bariatric Embolization of Arteries for the Treatment of Obesity (BEAT Obesity) trial found that obese people who underwent this procedure lost on average about 11 percent of their excess weight after 12 months.
Obesity is a major cause of morbidity and mortality affecting hundreds of millions of people worldwide. Limited effectiveness of the traditional methods (i.e. behavioral therapy, pharmacotherapy, diet modification, exercise) has driven the development of surgical interventions including gastric banding, sleeve gastrectomy, and gastric bypass. These procedures, although effective but pose risks. Thus, there arises a need for minimally invasive techniques that influence appetite-mediating hormones in a safer, less invasive, and more cost-effective manner than surgical options.
Clifford R. Weiss, The Johns Hopkins University School of Medicine, Baltimore, and colleagues conducted the study to evaluate the safety and efficacy of bariatric embolization in severely obese adults at up to 12 months after the procedure.
This prospective study enrolled 20 participants (16 women) aged 27–68 years (mean ± standard deviation, 44 years ± 11) with mean body mass index of 45 ± 4.1. Transarterial embolization of the gastric fundus was performed using 300- to 500-µm embolic microspheres. Primary endpoints were 30-day adverse events and weight loss at up to 12 months.
Researchers found that:
- Bariatric embolization was performed successfully for all participants with no major adverse events.
- Eight participants had a total of 11 minor adverse events.
- Mean excess weight loss was 8.2% at 1 month, 11.5% at 3 months, 12.8% at 6 months, and 11.5% at 12 months.
- From baseline to 12 months, mean SF-36 scores increased (mental component summary, from 46 ± 11 to 50 ± 10, P = .44; physical component summary, from 46 ± 8.0 to 50 ± 9.3, P = .15) and mean IWQOL-Lite scores increased from 57 ± 18 to 77 ± 18.
- Hunger or appetite decreased for 4 weeks after embolization and increased thereafter, without reaching pre-embolization levels.
- Participants who underwent bariatric embolization showed evidence of metabolic change, with decreases in hemoglobin A1c and total cholesterol (independent of weight loss) and increases in high-density lipoprotein levels.
“This is a great step forward for this procedure in establishing early feasibility, safety, and early efficacy,” said Dr. Weiss. “It is fulfilling to all of us to see something that started as an idea develop through about a decade of research and then go all the way to an initial clinical trial.”
“Bariatric embolization is well tolerated and promotes clinically relevant weight loss in adults with severe obesity. It may provide needed assistance to patients who are struggling to succeed in lifestyle modification–based weight loss programs,” concluded the authors.
For detailed study follow the link: https://doi.org/10.1148/radiol.2019182354