Left gastric artery embolization as a treatment for obesity: systematic review and meta-analysis

Authors

DOI:

https://doi.org/10.33448/rsd-v10i1.11415

Keywords:

Gastric Artery; Obesity; Weight Loss; Embolization.

Abstract

Gastric artery embolization (GAE) is one of the minimally invasive therapies that have been studied as an alternative to bariatric surgery, in order to mitigate possible surgical complications. GAE has been performed for more than 40 years for the treatment of gastrointestinal hemorrhages, but more recently researchers have been studying the hypothesis that the procedure can be performed for anorexigenic purposes, associating the reduction in the production of the ghrelin hormone with the weight loss achieved. This systematic review aims to summarize the results obtained in the last 5 years, evaluating the efficacy and safety of GAE for anorexigenic purposes and its relation to the hormone ghrelin. Methodology: A cross-search was performed with the headings "gastric artery embolization" and "obesity", retrieved from DeCS / MeSH, in the Pubmed, MEDLINE and Cochrane Library databases. Results: This study revealed 87 obese patients undergoing embolization of the left gastric artery, with an average weight loss of 9.32% (T = 6.9 months) and an average reduction in serum ghrelin levels of 15.05% (T = 6 months). Discussion: So far, the results suggest that GAE may be a safe, but not effective, technique for the treatment of obesity. Final remarks: Considering that bariatric surgery provides sustained weight loss between 45-80% in up to 2 years, tests with higher N are needed to assess sustained weight loss proportionally to the drop in ghrelin levels, because the association between these variables is not proven statistically. In addition, longer-term research is needed to analyze potential long-term complications.

References

Abu Dayyeh, B. K., Edmundowicz, S., & Thompson, C. C. (2017). Clinical practice update: Expert review on endoscopic bariatric therapies. Gastroenterology, 152(4), 716-729. DOI: https://doi.org/10.1053/j.gastro.2017.01.035.

Angrisani, L., Santonicola, A., Vitiello, A., Ferraro, L., & Iovino, P. (2018). Reply to letter to the editor “Left gastric artery Embolization for weight loss—a dead-end procedure”. Obesity Surgery, 28(11), 3627-3628. DOI: https://doi.org/10.1007/s11695-018-3464-9.

Anton, K., Rahman, T., Bhanushali, A., & Patel, A. A. (2016). Bariatric left gastric artery Embolization for the treatment of obesity: A review of gut hormone involvement in energy homeostasis. American Journal of Roentgenology, 206(1), 202-210. DOI: https://doi.org/10.2214/ajr.15.14331.

Bai, Z., Qin, Y., Deng, G., Zhao, G., Zhong, B., & Teng, G. (2018). Bariatric Embolization of the left gastric arteries for the treatment of obesity: 9-Month data in 5 patients. Obesity Surgery, 28(4), 907-915. DOI: https://doi.org/10.1007/s11695-017-2979-9.

Bai, Z., Zhong, B., & Teng, G. (2018). Response to letter of “Left gastric artery Embolization for weight loss—a Deadend procedure”. Obesity Surgery, 28(11), 3625-3626. DOI: https://doi.org/10.1007/s11695-018-3428-0.

Camilleri, M. (2015). Peripheral mechanisms in appetite regulation. Gastroenterology, 148(6), 1219-1233. DOI: https://doi.org/10.1053/j.gastro.2014.09.016.

Carvalho, M.N., Moura Filho, E.P., Silva, I.M.O., Souza, L.K.M. (2018). Embolização de ramos da artéria gástrica esquerda como tratamento neuroendócrino para obesidade: uma revisão sistemática [Poster session]. 1ª Jornada Acadêmica de Medicina, Instituto de Educação Superior do Vale do Parnaíba - IESVAP.

Clarivate Analytics. (2019). EndNote ®, Reference Management Software [Computer software]. Retrieved from https://www.endnote.com/?_ga=2.109951301.1174758763.1608831209-97773908.1607451281

Fink, J. M., Martini, V., Seifert, G., & Marjanovic, G. (2018). Left gastric artery Embolization for weight loss—a dead-end procedure. Obesity Surgery, 28(11), 3623-3624. DOI: https://doi.org/10.1007/s11695-018-3427-1.

Gilchrist, I. C. (2019). A catheter-based bariatric procedure: Wishful thinking or an intriguing concept. Catheterization and Cardiovascular Interventions, 93(3), 371-372. DOI: https://doi.org/10.1002/ccd.28139.

Gunn, A. J., & Oklu, R. (2014). A preliminary observation of weight loss following left gastric artery Embolization in humans. Journal of Obesity, 2014, 1-4. https://doi.org/10.1155/2014/185349.

Hafezi-Nejad, N., Bailey, C. R., Gunn, A. J., & Weiss, C. R. (2019). Weight loss after left gastric artery Embolization: A systematic review and meta-analysis. Journal of Vascular and Interventional Radiology, 30(10), 1593-1603.e3. https://doi.org/10.1016/j.jvir.2019.06.020.

IONDEV SRL. (2013). QTIPLOT ® - Data Analysis and Scientific Visualization [Computer software]. Retrieved from https://www.qtiplot.com/index.html

Kipshidze, N., Archvadze, A., Bertog, S., Leon, M. B., & Sievert, H. (2015). Endovascular bariatrics. JACC: Cardiovascular Interventions, 8(12), 1641-1644. https://doi.org/10.1016/j.jcin.2015.07.016.

Kordzadeh, A., Lorenzi, B., Hanif, M. A., & Charalabopoulos, A. (2018). Left gastric artery Embolisation for the treatment of obesity: A systematic review. Obesity Surgery, 28(6), 1797-1802. https://doi.org/10.1007/s11695-018-3211-2.

Moher, D. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine, 151(4), 264. https://doi.org/10.7326/0003-4819-151-4-200908180-00135

Neylan, C. J., Dempsey, D. T., Tewksbury, C. M., Williams, N. N., & Dumon, K. R. (2016). Endoscopic treatments of obesity: A comprehensive review. Surgery for Obesity and Related Diseases, 12(5), 1108-1115. https://doi.org/10.1016/j.soard.2016.02.006.

Noncommunicable diseases country profiles 2018 (2018). Geneva: World Health Organization. License: CC BY-NC-SA 3.0 IGO.

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. NTE. https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf?sequence=1

Pereira, K., Salsamendi, J., Kang, K., & Fan, J. (2015). Minimally invasive percutaneous endovascular therapies in the management of complications of non-alcoholic fatty liver disease (NAFLD): A case report. Journal of Radiology Case Reports, 9(9), 36-43. DOI: https://doi.org/10.3941/jrcr.v9i9.2557.

Pirlet, C., Ruzsa, Z., Costerousse, O., Nemes, B., Merkely, B., Poirier, P., & Bertrand, O. F. (2018). Transradial left gastric artery embolization to treat severe obesity: A pilot study. Catheterization and Cardiovascular Interventions, 93(3), 365-370. https://doi.org/10.1002/ccd.27846.

Shoar, S., Saber, A. A., Aladdin, M., Bashah, M. M., AlKuwari, M. J., Rizwan, M., & Rosenthal, R. J. (2016). Bariatric manipulation of gastric arteries: A systematic review on the potential concept for treatment of obesity. International Journal of Surgery, 36, 177-182. https://doi.org/10.1016/j.ijsu.2016.10.014.

Syed, M. I., Morar, K., Shaikh, A., Craig, P., Khan, O., Patel, S., & Khabiri, H. (2016). Gastric artery Embolization trial for the lessening of appetite Nonsurgically (GET LEAN): Six-month preliminary data. Journal of Vascular and Interventional Radiology, 27(10), 1502-1508. https://doi.org/10.1016/j.jvir.2016.07.010.

Takahashi, E. A., Takahashi, N., Reisenauer, C. J., Moynagh, M. R., & Misra, S. (2019). Body composition changes after left gastric artery embolization in overweight and obese individuals. Abdominal Radiology, 44(7), 2627-2631. https://doi.org/10.1007/s00261-019-02002-6.

Weiss, C. R., Abiola, G. O., Fischman, A. M., Cheskin, L. J., Vairavamurthy, J., Holly, B. P., Akinwande, O., Nwoke, F., Paudel, K., Belmustakov, S., Hong, K., Patel, R. S., Shin, E. J., Steele, K. E., Moran, T. H., Thompson, R. E., Dunklin, T., Ziessman, H., Kraitchman, D. L., & Arepally, A. (2019). Bariatric Embolization of arteries for the treatment of obesity (BEAT obesity) trial: Results at 1 year. Radiology, 291(3), 792-800. DOI: https://doi.org/10.1148/radiol.2019182354.

Weiss, C. R., Akinwande, O., Paudel, K., Cheskin, L., Holly, B., Hong, K., Fischman, A. M., Patel, R. S., Shin, E., Steele, K., Moran, T. H., Kaiser, K., Shade, D., Kraitchman, D. L., & Arepally, A. (2016). Bariatric Embolization of Arteries for the Treatment of Obesity (BEAT Obesity) Clinical Trial: 6-month Safety, Feasibility and Early Efficacy [Conference presentation]. https://www.hopkinsmedicine.org/institute_basic_biomedical_sciences/news_events/boot_camp/2016_weighty_matters/cliff%20weiss%20presentation.

Weiss, C. R., Gunn, A. J., Kim, C. Y., Paxton, B. E., Kraitchman, D. L., & Arepally, A. (2015). Bariatric Embolization of the gastric arteries for the treatment of obesity. Journal of Vascular and Interventional Radiology, 26(5), 613-624. DOI: https://doi.org/10.1016/j.jvir.2015.01.017.

Weiss, C. R., & Kathait, A. S. (2017). Bariatric embolization: A new and effective option for the obese patient? Expert Review of Gastroenterology & Hepatology, 11(4), 293-302. DOI: https://doi.org/10.1080/17474124.2017.1294060.

Zaitoun, M. M., Basha, M. A., Hassan, F., Elsayed, S. B., Farag, A. A., Amer, M., Aly, S. A., & Zaitoun, N. (2019). Left gastric artery Embolization in obese, Prediabetic patients: A pilot study. Journal of Vascular and Interventional Radiology, 30(6), 790-796. DOI: https://doi.org/10.1016/j.jvir.2019.02.010.

Zhong, B., Abiola, G., & Weiss, C. R. (2018). Bariatric arterial Embolization for obesity: A review of early clinical evidence. Cardiovascular and Interventional Radiology, 41(11), 1639-1647. DOI: https://doi.org/10.1007/s00270-018-1996-y.

Published

01/01/2021

How to Cite

OLIVEIRA, R. A. D. de .; LIMA, E. T.; LEÃO, L. C. da S.; MARTINS NETO, M. M. . Left gastric artery embolization as a treatment for obesity: systematic review and meta-analysis. Research, Society and Development, [S. l.], v. 10, n. 1, p. e1510111415, 2021. DOI: 10.33448/rsd-v10i1.11415. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/11415. Acesso em: 4 nov. 2024.

Issue

Section

Health Sciences