Transcatheter Bariatric Surgery?

This pilot study has shown transcatheter embolotherapy targeted to the left gastric artery is well tolerated and promotes significant weight reduction compared against a sham procedure.

¿Cirugía bariátrica por cateterismo?

Obesity has been linked to higher rates of cardiovascular and metabolic events. Diets and medical strategies are often ineffective and hardly sustainable over time. 

Bariatric procedures, though effective, are usually reserved to treat morbid obesity given the risks involved in surgical procedures. 

Pre-clinical studies have shown transcatheter bariatric embolotherapy to the left gastric artery reduces weight by limiting blood supply to the gastric fundus, which contains the majority of cells that produce ghrelin, the only known appetite stimulating hormone.

The aim of this study recently published in JACC was to examine the efficacy of embolotherapy in a randomized double-blind study vs. a sham procedure. 

It included 44 patients with BMI between 35 and 55 kg/m2 randomized 1:1 to a sham procedure vs.  transcatheter embolotherapy targeting the left gastric artery using an occlusion balloon microcatheter to administer 300- to 500-mm embolic beads. 


Read also: Bariatric Surgery Associated with a Lower Rate of Mortality Due to Infarction and Stroke.


All patients entered a lifestyle counseling program. Patients and physicians performing follow-up were blind to the allocated therapy. Endoscopy was performed at baseline and 1-week post-procedure. Primary end point was weight loss at 6 months.

There were no procedural complications, and just one vascular complication. 

Patients reported mild nausea and endoscopy revealed only minor self-limiting ulcers in five patients. 


Read also: Low-Carb Diet and Coronary Artery Calcium Progression.


At 6-month followup, total weight loss resulted superior in patients undergoing transcatheter embolotherapy vs. patients randomized to the sham procedure (9.4 kg/8.3% vs 1.9 kg/1.8%, respectively, per-protocol). This difference was sustained at one year, still significant vs. sham procedure. 

Conclusion

This pilot study has shown transcatheter embolotherapy to the left gastric artery achieves significant weight loss compared against a sham procedure. 

Original Title: Transcatheter Bariatric Embolotherapy for Weight Reduction in Obesity.

Reference: Vivek Y. Reddy et al. J Am Coll Cardiol 2020;76:2305–17. https://doi.org/10.1016/j.jacc.2020.09.550.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

 

More articles by this author

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....

Chronic Thromboembolic Pulmonary Hypertension: Treatment Outcomes According to a Worldwide Registry

Chronic thromboembolic pulmonary hypertension (CTEPH) is a highly limiting condition that, despite its moderate incidence, significantly impacts patient prognosis and quality of life. The...

Contemporary Outcomes of Acute Limb Ischemia Endovascular Revascularization

Acute limb ischemia (ALI) is a vascular emergency with high mortality rate. It has been defined as a sudden occlusion of limb perfusion compromising...

TCT 2024 | SIRONA: Randomized Study Comparing Sirolimus-Coated vs Paclitaxel-Coated Balloon Angioplasty in Femoropopliteal Disease

This prospective, randomized, multicenter, investigator-initiated non-inferiority study compared the use of sirolimus-coated balloon (MagicTouch) vs paclitaxel-coated balloon in endovascular treatment.  The primary objective was to...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....