Significance of Distal Embolization of the Right Gastroepiploic Artery in Bariatric Gastric Embolization

Background: Embolization of the arteries supplying the gastric fundus results in decrease in Ghrelin production with secondary decease in appetite. Methods: Four patients with morbid obesity ranging from 35 to 45 body mass index had left gastric embolization. Right gastroepiploic artery embolization was done in three of them, one simultaneous with left gastric embolization in one session and the other two patients in second separate session. Two milliliters of microspheres 300–500 U was used for left gastric embolization and 1–1.5 ml for the right gastroepiploic artery. Results: Significant decrease in hunger pain in the four patients is noted in the first 2 weeks. After 2 weeks, the hunger pain differs in the four patients. Two patients with left gastric artery embolization only lost satiety after 3–4 weeks from embolization. Second session of embolization showed the persistence of left gastric artery occlusion, while the gastroepiploic artery showed relative increase in its perfusion of the gastric fundus. Distal right gastroepiploic artery embolization was performed for these two patients in the second separate session. Satiety is resumed with persistent hunger score 3 out of 10 scales for 3 months. The percentage of body weight loss in 3-month follow-up ranged from 8% to 12% where better results are noted in the two patients with two sessions embolization. Conclusion: Bariatric gastric embolization gives better results with embolization of both left gastric and right gastroepiploic arteries and better in two separate sessions without adding any significant morbidity. Publication History Article published online: 11 May 2021 © 2018. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). Thieme Medical and Scientific Publishers Pvt. Ltd. A-12, 2nd Floor, Sector 2, Noida-201301 UP, India