Doctors perform first U.S. bariatric embolization procedure to treat obesity

DAYTON, Ohio, Nov. 18, 2014 /PRNewswire/ -- A new procedure to combat obesity was recently performed by physicians at Dayton Interventional Radiology. Bariatric embolization is a minimally invasive technique whereby a small catheter is introduced into the groin or wrist and guided into the left gastric artery that supplies the upper stomach. Particles smaller than a grain of sand are then injected into the left gastric artery to block blood flow—or embolize—the tiny branches of this artery. This is expected to decrease the hormone ghrelin, responsible for appetite, resulting in weight loss. This is the first catheter-based procedure that attempts to directly address obesity, one of the largest public health problems in the United States.

Under the supervision of lead investigator Mubin I. Syed, MD, of Dayton Interventional Radiology, and in conjunction with The Ohio State University Wexner Medical Center, the outcomes of the Gastric Artery Embolization Trial for Lessening Appetite Nonsurgically (GET LEAN) study could pave the way to a minimally invasive treatment for obesity. 

Embolization is a procedure that has been performed for decades to stop life-threatening bleeding in a variety of organs including the stomach; bariatric embolization is a variant of this procedure. Animal studies at Johns Hopkins University and Duke University, using the left gastric artery embolization technique, showed significant ghrelin suppression and weight loss. Recently, researchers at Harvard University retrospectively noticed that patients undergoing gastric artery embolization to combat bleeding also lost 8% of their body weight, on average. The first and only other study in humans utilizing bariatric embolization for weight loss was conducted in the Georgian Republic (former Soviet Union). In that 2013 study, five patients lost an average of 45 pounds within six months. 

"We are combining years of scientific research on the hormone ghrelin, looking at its role with respect to appetite suppression, and combining it with an everyday type of embolization procedure that interventional radiologists routinely perform," states Kamal Morar, MD, one of the study's principal investigators.

The current research on this groundbreaking procedure concludes in September 2015 and will collect data on safety and efficacy for those patients who are morbidly obese (defined as having a BMI greater than 40). Qualified patients are between the ages of 22 and 65, in relatively good health and under 400 pounds. The GET LEAN study will look at changes in participants' overall weight, changes in BMI, changes in appetite hormone levels and at quality of life data, while measuring adverse events. This FDA supervised study was issued an investigational device exemption (IDE). 

"More than one-third of U.S. adults are obese and approximately 5 to 7% are morbidly so," explained Dr. Syed. Currently, the only proven long-term procedural solution for substantial weight loss is bariatric surgery, an often extensive operation. "You've got the ideal rationale to develop a minimally invasive procedure that could deliver long-term success. To me that's promising, and why I practice medicine." He further advised, "Despite the potential to help the obese, bariatric embolization is still in the experimental phase. Therefore, its safety and long-term benefit has yet to be proven."

Interventional radiology is a medical sub-specialty of radiology that uses minimally invasive, image-guided procedures to diagnose and treat diseases in nearly every organ system. The guiding principle is to utilize the least invasive techniques in order to minimize patient risk and improve outcomes.

"To realize that the knowledge I have as an interventional radiologist could potentially solve an issue, which personally affects several family members and friends, was very humbling," said Dr. Syed.

Reference
http://www.clinicaltrials.gov/ct2/show/NCT02248688?term=bariatric+embolization&rank=2

SOURCE Dayton Interventional Radiology