Bariatric Artery Embolization for Treatment of Obesity; Is It Safe to Embolize All Fundal Blood Supply? An Egyptian Experience in 12 Cases

Objectives: Left gastric artery (LGA) embolization to decrease appetite by the closure of blood supply to the fundal glands secreting “ghrelin” (Hunger hormone), also known as bariatric artery embolization (BAE), has experienced increased acceptance worldwide. Fundal dual blood supply from the LGA and right gastroepiploic artery (RGEA) is rather common. Our study aims to assess the safety and preliminary weight loss in patients with embolized dual fundal supply. Methods: Since 2016, 45 obese cases with mean body mass index (BMI, 36.7) presented to us for BAE. LGA and RGEA were superselectively catheterized in all patients revealing dual fundal supply in 12 patients and were embolized with 300–500 μ spherical particles with complete cessation of fundal blood supply as angiographic endpoint. Close monitoring of the complications was done. Weight was measured at 1, 3, and 6 months. Results: In 12 patients, no major complications were occurred. Vomiting and epigastric pain were seen in various degrees in all patients; two patients developed mild self-limiting coffee ground hematemesis for 2 days treated conservatively. Patients reported marked subjective decrease in appetite in the 1^st month with slight recovery of appetite during follow-up. BMI decreased from 36.4 to 31.7, 30.5, and 30.2 at 1, 3, and 6 months, respectively. Conclusion: In our small series, LGA and RGEA embolization has shown to be a safe technique in controlling appetite, leading to short-term weight loss. With its minimally invasive nature, it can become a promising procedure in the treatment of overweight/obesity.

Publication History

Article published online:
26 April 2021