Clifford R Weiss1, Yingli Fu2, Cyrus Beh3, Charles Hu4, Dorota Kedziorek2, Eun-Ji Shin5, Robert A Anders6, Aravind Arepally7, Dara L Kraitchman2. 1. Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: cweiss@jhmi.edu. 2. Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland. 3. Biomedical Engineering Department, Johns Hopkins University, Baltimore, Maryland. 4. Material Science and Engineering, Johns Hopkins University, Baltimore, Maryland. 5. Department of Gastroenterology, Johns Hopkins University School of Medicine, Baltimore, Maryland. 6. Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland. 7. Department of Radiology, Piedmont Healthcare, Atlanta, Georgia.
Abstract
PURPOSE: To examine safety and efficacy of bariatric arterial embolization (BAE) with x-ray-visible embolic microspheres (XEMs) and an antireflux catheter in swine. MATERIAL AND METHODS: BAE with selective infusion of XEMs (n = 6) or saline (n = 4, control) into gastric fundal arteries was performed under x-ray guidance. Weight and plasma hormone levels were measured at baseline and weekly for 4 weeks after embolization. Cone-beam CT images were acquired immediately after embolization and weekly for 4 weeks. Hormone-expressing cells in the stomach were assessed by immunohistochemical staining. RESULTS: BAE pigs lost weight 1 week after embolization followed by significantly impaired weight gain relative to control animals (14.3% vs 20.9% at 4 weeks, P = .03). Plasma ghrelin levels were significantly lower in BAE pigs than in control animals (1,221.6 pg/mL vs 1,706.2 pg/mL at 4 weeks, P < .01). XEMs were visible on x-ray and cone-beam CT during embolization, and radiopacity persisted over 4 weeks (165.5 HU at week 1 vs 158.5 HU at week 4, P = .9). Superficial mucosal ulcerations were noted in 1 of 6 BAE animals. Ghrelin-expressing cell counts were significantly lower in the gastric fundus (17.7 vs 36.8, P < .00001) and antrum (24.2 vs 46.3, P < .0001) of BAE pigs compared with control animals. Gastrin-expressing cell counts were markedly reduced in BAE pigs relative to control animals (98.5 vs 127.0, P < .02). Trichrome staining demonstrated significantly more fibrosis in BAE animals compared with control animals (13.8% vs 8.7%, P < .0001). CONCLUSIONS: XEMs enabled direct visualization of embolic material during and after embolization. BAE with XEMs and antireflux microcatheters was safe and effective.
PURPOSE: To examine safety and efficacy of bariatric arterial embolization (BAE) with x-ray-visible embolic microspheres (XEMs) and an antireflux catheter in swine. MATERIAL AND METHODS: BAE with selective infusion of XEMs (n = 6) or saline (n = 4, control) into gastric fundal arteries was performed under x-ray guidance. Weight and plasma hormone levels were measured at baseline and weekly for 4 weeks after embolization. Cone-beam CT images were acquired immediately after embolization and weekly for 4 weeks. Hormone-expressing cells in the stomach were assessed by immunohistochemical staining. RESULTS: BAE pigs lost weight 1 week after embolization followed by significantly impaired weight gain relative to control animals (14.3% vs 20.9% at 4 weeks, P = .03). Plasma ghrelin levels were significantly lower in BAE pigs than in control animals (1,221.6 pg/mL vs 1,706.2 pg/mL at 4 weeks, P < .01). XEMs were visible on x-ray and cone-beam CT during embolization, and radiopacity persisted over 4 weeks (165.5 HU at week 1 vs 158.5 HU at week 4, P = .9). Superficial mucosal ulcerations were noted in 1 of 6 BAE animals. Ghrelin-expressing cell counts were significantly lower in the gastric fundus (17.7 vs 36.8, P < .00001) and antrum (24.2 vs 46.3, P < .0001) of BAE pigs compared with control animals. Gastrin-expressing cell counts were markedly reduced in BAE pigs relative to control animals (98.5 vs 127.0, P < .02). Trichrome staining demonstrated significantly more fibrosis in BAE animals compared with control animals (13.8% vs 8.7%, P < .0001). CONCLUSIONS: XEMs enabled direct visualization of embolic material during and after embolization. BAE with XEMs and antireflux microcatheters was safe and effective.
Authors: Clifford R Weiss; Olaguoke Akinwande; Kaylan Paudel; Lawrence J Cheskin; Brian Holly; Kelvin Hong; Aaron M Fischman; Rahul S Patel; Eun J Shin; Kimberley E Steele; Timothy H Moran; Kristen Kaiser; Amie Park; David M Shade; Dara L Kraitchman; Aravind Arepally Journal: Radiology Date: 2017-02-14 Impact factor: 11.105
Authors: Ben E Paxton; Charles Y Kim; Christopher L Alley; Jennifer H Crow; Bryan Balmadrid; Christopher G Keith; Ravi J Kankotia; Sandra Stinnett; Aravind Arepally Journal: Radiology Date: 2012-11-30 Impact factor: 11.105
Authors: Alexander S Pasciak; Austin C Bourgeois; Ben E Paxton; Laurentia Nodit; Patricia N Coan; Dara Kraitchman; Sandra S Stinnett; Vijay M Patel; Yingli Fu; Joleen K Adams; M Katherine Tolbert; Cassie N Lux; Aravind Arepally; Yong C Bradley Journal: J Vasc Interv Radiol Date: 2016-08-01 Impact factor: 3.464
Authors: Ben E Paxton; Christopher L Alley; Jennifer H Crow; James Burchette; Clifford R Weiss; Dara L Kraitchman; Aravind Arepally; Charles Y Kim Journal: J Vasc Interv Radiol Date: 2014-01-21 Impact factor: 3.464
Authors: Jenanan Vairavamurthy; Frank Yuan; Robert A Anders; Dara L Kraitchman; Clifford R Weiss Journal: J Vasc Interv Radiol Date: 2022-01 Impact factor: 3.464
Authors: Olaguoke Akinwande; Frank Yuan; Godwin O Abiola; Brian P Holly; Aravind Arepally; Percy Genyk; Tina Ehtiati; Yingli Fu; Dara L Kraitchman; Clifford R Weiss Journal: J Vasc Interv Radiol Date: 2022-06 Impact factor: 3.682