Bariatric embolization for obesity: a critical review

1. To introduce interventional radiologists to the science behind Bariatric Arterial Embolization (BAE) and how it could be used to help treat obesity 2. To review the current literature pertaining to BAE, including the preclinical and clinical studies. 3. To give insight on future directions/investigations on this topic. BAE is a catheter-directed technique for the treatment of obesity. It involves embolization of the arterial supply to the fundus of the stomach with the goal of reducing the production of Ghrelin. Ghrelin is a potent orexigenic (appetite stimulating) hormone which is released from the fundus of the stomach. In animal models, BAE has been shown to reduce ghrelin levels and lead to reductions in weight or weight gain in growing animals. FDA_approved clinical trials are now underway to determine the safety of BAE in human subjects. Relevant findings in preclinical and clinical studies relating to bariatric embolization will be reviewed. Content will be organized as follows: A. BAE background, rationale and hormonal physiology. B. Review of bariatric arterial anatomy in swine and human subjects. C. Critical review of the current preclinical studies: safety, feasibility and efficacy D. Critical review of previous and current early clinical studies: safety, feasibility and efficacy. E. Insight into future directions and upcoming studies pertaining to BAE. Bariatric embolization effectively modulates ghrelin levels in animal studies resulting in weight loss or reductions in weight gain. Early results of BAE in human subjects indicate that the procedure can be performed safely. Continuing clinical studies will help establish the durable efficacy of BAE in humans.