Bariatric Embolization - The Who, What, Why, and Where Are We Now?

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Purpose :
The purpose of this exhibit is to review the pathophysiology, anatomy, technical details of embolization, and the most up to date literature surrounding left gastric artery (LGA) embolization as it relates to its role in bariatric therapy.
Materials & Methods :
Obesity is an epidemic in the USA, with the CDC estimating the prevalence of obesity to be up to 42% in American adults. Some of the leading causes of preventable adult death are directly related to obesity. Traditionally, invasive bariatric surgery, such as Roux-en-Y gastric bypass or gastric banding, has been considered for severe cases; these surgeries have varied results and adverse outcomes. It has become imperative to devise a novel minimally invasive way to treat the obesity pandemic.
The advent of minimally invasive procedures has unsurprisingly changed the landscape of obesity treatment - namely, through the embolization of the LGA. The LGA has a varied origin from the aorta, and travels along the lesser curvature of the stomach towards the fundus, giving off branches that feed the gastric mucosa. It anastomoses with the right gastric artery along the lesser curvature of the stomach. Embolization of the LGA leads to a decreased number of available gastric cells that secrete ghrelin within the gastric fundus, an orexigenic hormone that stimulates appetite and induces increased levels of growth hormone. Recent studies have shown significant weight loss in patients with LGA (up to 17.19%). Mild adverse events have been reported, including nausea and vomiting, in addition to more serious events such as ulcer formation.
Results :
In this education exhibit, we will first review the relevant anatomy involved in LGA embolization using original schematics and drawings, including the various origins of the LGA, and the technical aspects of access and embolization. Next, the rationale behind embolization of the LGA will be explored, and attention will be given to the role of hormonal alterations as a result of LGA embolization, including the roles of ghrelin and leptin. Lastly, a concise summary of the most current clinical trials in bariatric embolization will be presented, with a look towards future challenges.
Conclusions :
The minimally invasive technique used in LGA embolization has the potential to revolutionize bariatric therapy. We review the most current data surrounding LGA embolization in hopes to familiarize our readers with an exciting forefront in managing the obesity crisis.
Poster Abstract :
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Radiology Resident
SUNY Upstate Medical University
SUNY Upstate Medical University
SUNY Upstate Medical University
SUNY Upstate Medical University

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