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Bariatric Arterial Embolization with Non-spherical Polyvinyl Alcohol Particles for Ghrelin Suppression in a Swine Model

  • Jae Min Kim
  • Man-Deuk KimEmail author
  • Kichang Han
  • Lailatul Muqmiroh
  • Seung Up Kim
  • Gyoung Min Kim
  • Joonho Kwon
  • Sung Il Park
  • Jong Yun Won
  • Do Yun Lee
Laboratory Investigation

Abstract

Purpose

To evaluate the effect of bariatric arterial embolization (BAE) with non-spherical polyvinyl alcohol (PVA) particles on systemic ghrelin levels, weight change, and gastric ulceration risk in a swine model.

Materials and Methods

From March 2014 to February 2015, ten healthy swine were used in the study (mean weight 31.5 kg; range 24.0–41.5 kg). The animals were randomly assigned to two groups: the embolized group (n = 5) in which BAE was performed and the control group (n = 5). In the embolized group, BAE was performed by selectively infusing 150–250 or 50–150 μm PVA into the gastric arteries that supplied the fundus of the stomach. In the control group, a sham procedure was performed with saline infusion. Plasma ghrelin levels were prospectively obtained at baseline and every 2 weeks thereafter. Endoscopy was performed 3 weeks after BAE to see whether any gastric ulcer occurred. To determine the durability of the occluded arteries, repeated celiac trunk angiography was performed 8 weeks after BAE. Then, all the swine were killed and necropsies were performed.

Results

The mean post-procedure ghrelin value decreased by 370.0 pg/mL in the embolized group at week 3 (mean 536.0 ± 334.3 pg/mL) and week 5 (mean 515.0 ± 150.0 pg/mL, p < 0.05) relative to baseline (880.0 ± 559.5 pg/mL), respectively, but ghrelin levels were not significantly decreased between the embolized and control groups. There was a significant body weight change as follows: 35.1 ± 9.5 to 46.6 ± 15.7 kg and 31.8 ± 5.8 to 41.2 ± 6.6 kg at baseline and endpoint in the control and embolized groups, respectively (p < 0.05). However, the difference between groups was not significant at endpoint. In the embolized group, ulcerations were identified in three animals (60%) and the recanalization of the embolized arteries was noted on follow-up angiography in three animals (60%), respectively.

Conclusion

BAE with PVA particles can transiently suppress ghrelin levels in embolized animals, but levels are not significantly different compared to controls. Stomach ulcerations were identified in 60% of the embolized animals.

Keywords

Bariatric embolization Ghrelin Gastric artery embolization Obesity Weight loss 

Notes

Acknowledgements

M.D.K received a research money grant from Dasol Life Science Inc. (Grant No. 2013-31-0633).

Compliance with Ethical Standards

Conflict of interest

None of authors have conflict of interest.

Ethical Approval

All applicable institutional guidelines for the care and use of animals were followed.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2017

Authors and Affiliations

  • Jae Min Kim
    • 1
  • Man-Deuk Kim
    • 1
    Email author
  • Kichang Han
    • 1
  • Lailatul Muqmiroh
    • 1
  • Seung Up Kim
    • 2
  • Gyoung Min Kim
    • 1
  • Joonho Kwon
    • 1
  • Sung Il Park
    • 1
  • Jong Yun Won
    • 1
  • Do Yun Lee
    • 1
  1. 1.Department of Radiology, Research Institute of Radiological Science, Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea
  2. 2.Department of Internal Medicine, Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea

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