Weight Loss after Left Gastric Artery Embolization: A Systematic Review and Meta-Analysis.

Abstract

A systematic review of clinical trials investigating the safety and efficacy of left gastric artery (LGA) embolization as a bariatric procedure was performed. The Methodological Index for Nonrandomized Studies (MINORS) instrument was used for quality assessment. Patient characteristics, weight loss after embolization, and complications were reviewed. Meta-regression was performed to assess associations of age, sex, body mass index, and ghrelin and leptin levels with weight change after LGA embolization. The final meta-analysis included 6 nonrandomized prospective trials. Findings of 3 additional studies reporting weight changes after LGA embolization for control of gastrointestinal bleeding were also reviewed. Pooled analysis of 47 subjects with overweight/obesity showed mean ± SD weight loss after embolization of 8.1% ± 1.5% and 8.85 kg ± 1.24 kg (both P < .001) after a mean 12-month follow-up. Male sex (β= 11.36 ± 5.79, P= .049) was associated with greater weight loss. Transient superficial mucosal ulcers were common after LGA embolization. One major adverse event comprising severe pancreatitis, splenic infarct, and gastric perforation was reported; treatment was supportive care. LGA embolization was associated with statistically significant weight loss and limited complications during short-term follow-up. Given that LGA embolization is an investigative method, it is important for researchers to follow standardized protocols and techniques to avoid complications.