BARIATRIC EMBOLIZATION OF ARTERIES FOR THE TREATMENT OF OBESITY

Abstract

Obesity is now an important problem allover the worlddue to its multiple co-morbidities and its marked harmful effect onthe lifestyle of the patient. Obesity is a multifactorial condition that isinfluenced by genetics, the environment, other diseases, drugs, andpsychologic factors. As with other multifactorial conditions, treatmentof obesityrequires that a multidisciplinaryapproach be tailored to the individual. Thetreatment is medical or surgical.The major components of medical treatment are caloric reduction and increased physical activity and exercise. Despite being associated with early benefits, life style and dietary changes have proven ineffective as long-term treatment of most strategies. Surgical treatment for obesity has proved that it is the best and most effective, durable means of preventing the life-threatening complications and serious problems associated with morbid obesity despite the long list of associated morbid complications. Thus, there is a critical need for a minimally invasive image-guided intervention that does not cause morbid complication as bariatric surgery as LGA embolization.An other advantage is that LGA embolization can be employed in morbidly obese patients who are too critically ill for an invasive procedure as a mean to weight loss because the procedure is performed under local anesthesia. The rationale behind this idea is that left gastric artery embolization can cause localized ischemia in the region of ghrelin production, which can therefore reduce ghrelin levels and reduce appetite without Ischemic complications occurance, as a result of the foregut’s rich collateral blood supply. Several preclinical studies showed significant reductions in both the systemic ghrelin level and the amount of weight gain over the course of the study when compared with systemic ghrelin level and amount of weight gain in animals that did not undergo embolization. Thesestudies highlight the potential that gastric artery embolization may be used in the treatment of obesity patient. Although similar in design, thesestudies each have differences that become important when putting together a protocol for investigation of this technique in humans. Despite promising animal data, weight loss in humans after LGA embolization has not been sufficiently documented.