JVIR twitter

Friday, April 3, 2015

Bariatric Embolization for the Treatment of Obesity: A Review

Bariatric embolization has been discussed as a possible treatment for obesity since first early pre-clinical studies were done by Arepally et al in 2007. While much work in this field has been done, there remain many challenges prior to full clinical implementation. The current state of BAE was recently reviewed in JVIR by researchers from Johns Hopkins. Weiss et al. provide a thorough review of the physiologic and anatomic basis along with a review of the preclinical and clinical data. If successful, BAE will represent a minimally invasive solution to obesity offered by interventional radiologists.


Comment:
This manuscript does an excellent job reviewing the topic of BAE. The physiologic and anatomic basis for the procedure along with the current preclinical and clinical data are reviewed well. Clearly there are many challenges to mainstream implementation of this procedure. Many questions remain unanswered. What is the ideal embolic agent? What is the long-term outcome and will this procedure result in sustained weight loss? What is the best method of targeting the appropriate vascular bed? As more robust clinical trials provide answers to these questions, we will be closer to understanding the role this procedure may have in the treatment of this prevalent disease process.


Click here to see the full abstract




Angiogram of the left gastric artery. Fundal (solid arrows) and esophageal (dashed arrow) branches are identified. This LGA shows a large anastomosis (arrowheads) with the right gastric artery along the lesser curvature.


Hormonal changes during the fasting versus fed states. Several hormones are released from the GI tract. The “hunger hormone” ghrelin is secreted from X/A cells in the gastric fundus, whereas PYY and GLP-1 are secreted from L cells, primarily from the ileum and colon. Leptin is primarily produced in adipocytes. During fasting, decreased food intake suppresses the release of PYY, GLP-1, and CCK from the gut while stimulating the secretion of ghrelin by the stomach. Fasting also decreases serum leptin levels. These changes are detected by the brain, leading to hunger. Dieting results in a gut hormone profile that mimics the fasted state. During and after regular feeding, there is a reduction in the production of ghrelin by the stomach. In contrast, production of PYY, GLP-1, and CCK from the gut is increased, and serum leptin levels also increase. These changes, which are detected by the brain, result in decreased appetite and a feeling of satiety.


Citation: Weiss, C. R. et al. Bariatric Embolization of the Gastric Arteries for the Treatment of Obesity. Journal of Vascular and Interventional Radiology (2015). doi:10.1016/j.jvir.2015.01.017


Post author: Luke Wilkins, MD


5 comments:

  1. I was diagnose with genital warts since 2012 i have be taking lot treatment and all i got is outbreak. in 2015 I gave up the treatment because I can't continues wasting time and money on treatment at the end it will not cure me. about 6 weeks ago i did natural research online I had So many people talking good about natural remedy, after the research i was recommended to Dr onokun, And I wrote to him through his email and told him my problem after some conversations with him he gave me natural treatment after 1 week Dr onokun treated me i got cured permanently. and i went to see my doc he confirmed that the diseases has gone out from my body. every patients should know there is 100% natural hpv cure. contact Dr onokun his email address: dronokunherbalcure@gmail.com

    ReplyDelete
  2. The greatest Joy in my life today is that i have been cured of HIV/AIDS by a Doctor called Dr. Aire,
    Dr. Aire help me in my life. I was infected with HIV/AIDS DISEASE in 2012, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution,so that my body can be okay.until this faithful day as i was browsing the net I saw a testimony on how Dr.Aire helped people in curing HIV disease, quickly I copied his WhatsApp number so i contacted him for solution for my HIV DISEASE,so Dr. Aire told me that his going to prepare herbal medicine for my health,then he prepared the medicine and luckily after 2week my HIV was cured. Dr.Aire is well recognize as one of the best herbalist doctor in Africa, you don't have to be sad anymore or share your tears anymore on this disease when the cure have already be found by Dr. Aire herbal medicine,he also cure HPV,CANCER,HERPES,ALS,HEPATITIS B, DIABETES, ASTHMA,contact him on his email (drairehome@gmail.com) or contact him on WhatsApp via number:+2347036740271

    ReplyDelete
  3. The greatest Joy in my life today is that i have been cured of HIV/AIDS by a Doctor called Dr. Aire,
    Dr. Aire help me in my life. I was infected with HIV/AIDS DISEASE in 2012, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution,so that my body can be okay.until this faithful day as i was browsing the net I saw a testimony on how Dr.Aire helped people in curing HIV disease, quickly I copied his WhatsApp number so i contacted him for solution for my HIV DISEASE,so Dr. Aire told me that his going to prepare herbal medicine for my health,then he prepared the medicine and luckily after 2week my HIV was cured. Dr.Aire is well recognize as one of the best herbalist doctor in Africa, you don't have to be sad anymore or share your tears anymore on this disease when the cure have already be found by Dr. Aire herbal medicine,he also cure HPV,CANCER,HERPES,ALS,HEPATITIS B, DIABETES, ASTHMA,contact him on his email (drairehome@gmail.com) or contact him on WhatsApp via number:+2347036740271

    ReplyDelete
  4. The greatest Joy in my life today is that i have been cured of HIV/AIDS by a Doctor called Dr. Aire,
    Dr. Aire help me in my life. I was infected with HIV/AIDS DISEASE in 2012, i went to many hospitals for cure but there was no solution, so I was thinking how can I get a solution,so that my body can be okay.until this faithful day as i was browsing the net I saw a testimony on how Dr.Aire helped people in curing HIV disease, quickly I copied his WhatsApp number so i contacted him for solution for my HIV DISEASE,so Dr. Aire told me that his going to prepare herbal medicine for my health,then he prepared the medicine and luckily after 2week my HIV was cured. Dr.Aire is well recognize as one of the best herbalist doctor in Africa, you don't have to be sad anymore or share your tears anymore on this disease when the cure have already be found by Dr. Aire herbal medicine,he also cure HPV,CANCER,HERPES,ALS,HEPATITIS B, DIABETES, ASTHMA,contact him on his email (drairehome@gmail.com) or contact him on WhatsApp via number:+2347036740271

    ReplyDelete
  5. I am John Danilla from UK( northern ireland), i want to share a
    testimony on how a powerful spell caster cured my HIV disease, i was
    diagnosed of this disease, in the year 2009, last week i saw a testimony on
    Dr.Akioya on how he cured an HIV patient, so i contacted him through phone
    and he asked me to email him, which idid, so he told me that all my
    problems is over and then he decided to do an healing spell spell for me so
    after he finished it, he told me to wait for just 24 hours and then i
    should go for a test, so i really did as he had said, so my greatest
    surprised when i went to the hospital to go for an HIV test, the Medical
    doctor diagnosed that, i am now HIV negetative at first i was amazed and
    now i have come to realise that this spell caster Dr. Akioya is a very
    powerful one and a real spell caster. So viewers of this should please join
    me in my celebration for i am the happiest man on earth today and if you
    want to contact him, you can do this via his email
    (drakioya17spellhome@gmail.com or call him or whatsapp him
    +2348105257464. or you can visit is website;
    http://drakioyaherbalcenter.home.blog
    https://drakioyaherbalhome.blogspot.com/

    ReplyDelete