Ben Eugene Paxton MD, Presenter: Nothing to Disclose

Charles Yoon Kim MD, Abstract Co-Author: Research grant, Lantheus Medical Imaging, Inc Speakers Bureau, Lantheus Medical Imaging, Inc

Christopher L. Alley MD, Abstract Co-Author: Nothing to Disclose

Jennifer H. Crow MD, Abstract Co-Author: Nothing to Disclose

Bryan Balmadrid MD, Abstract Co-Author: Nothing to Disclose

Christopher Gatlin Keith, Abstract Co-Author: Nothing to Disclose

Ravi Kankotia, Abstract Co-Author: Nothing to Disclose

Sandra Stinnett MS, MPH, Abstract Co-Author: Nothing to Disclose

Aravind Arepally MD, Abstract Co-Author: Nothing to Disclose

To prospectively test, in a porcine model, the hypothesis that catheter-directed gastric artery embolization with commercially available calibrated microspheres can result in long term suppression of systemic ghrelin levels, the hormone that regulates appetite, and affect weight gain, with minimal impact on the gastric mucosa.

This study, which had IACUC approval, was performed in healthy, growing swine (weight range, 36.6-47.0 kg; n = 9). Gastric artery embolization was performed in five swine with the infusion of 40μ Embozene Microspheres (4-6 mLs, Celonova, Peachtree City, GA) selectively into the gastric arteries that supply the fundus. Four control animals underwent a sham procedure with saline. Weight and fasting plasma ghrelin levels were obtained in animals at baseline and at weeks 1–7. Statistical testing for differences in ghrelin blood levels and weight at each time point was carried out using the Wilcoxon signed rank test for within group differences and the Wilcoxon rank sum test for between group differences. Endoscopic examinations of all stomachs were performed at 3 weeks. Histopathologic analysis of gastric mucosa was performed at study termination.  

The pattern of the change in ghrelin levels over time was significantly different between control and treated animals. In treated animals, ghrelin levels were significantly reduced at week 1 (mean 720.5 pg/mL ± 184.9 [SEM], P = 0.014), week 2 (mean 899.8 pg/mL ± 194.1, P = 0.027), week 3 (mean 762.3 pg/mL ± 64.7, P = 0.014), and week 6 (mean 1107.6 pg/mL ± 63.7, P = 0.025) relative to baseline (mean, 1644.6 pg/mL ± 267.6). The pattern of the change in weight over time was significantly different between control and treated animals at week 1 (mean change -1.3 kg ± 0.6, P = 0.014), week 3 (mean change 1.7 kg ± 0.6, P = 0.05), week 4 (mean change 3.3 kg ± 1.7, P = 0.014), and week 5 (4.1 kg ± 2.3, P = 0.05). At the end of 7 weeks, control swine continued to gain weight, with a 35.9% increase from their original weight, while the weight increase in swine treated with gastric artery embolization was blunted at an increase of 16.1% from their original weight. 

Catheter-directed gastric artery embolization can suppress the appetite hormone ghrelin and affect weight gain.

Gastric artery embolization may provide a minimally invasive image-guided alternative in targeting appetite and weight gain.  

Paxton, B, Kim, C, Alley, C, Crow, J, Balmadrid, B, Keith, C, Kankotia, R, Stinnett, S, Arepally, A, Catheter-directed Gastric Artery Embolization: Long-term Suppression of Systemic Ghrelin Levels in a Porcine Model Using Calibrated Microspheres.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11009365.html