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确定减肥栓塞的理想靶血管大小:猪和人胃底的组织学分析。

Identifying the Ideal Target Vessel Size for Bariatric Embolization: Histologic Analysis of Swine and Human Gastric Fundi.

机构信息

Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California.

Vascular and Interventional Radiology Center, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Hospital/The Johns Hopkins University, Baltimore, Maryland.

出版信息

J Vasc Interv Radiol. 2022 Jan;33(1):28-32. doi: 10.1016/j.jvir.2021.09.018.

Abstract

This study aimed to identify the ideal arteriole size to target in bariatric embolization, with the goal of maximizing weight loss efficacy while maintaining patient safety. Although all published clinical trials of bariatric embolization have used embolic microspheres that were at least 300 μm in diameter, optimal weight loss outcomes have been achieved safely in swine using 50-μm embolics. Human fundal remnants from bariatric surgery were compared with swine fundal sections after bariatric embolization with 50-μm embolic microspheres to assess the ideal fundal vessel size for bariatric embolization. In swine, the 50-μm embolic microspheres deposited in the luminal half of the submucosa with a mean arteriole size of 49 μm ± 30. The mean arteriole diameter in the corresponding submucosal layer of the human gastric fundi was 40 μm ± 30. These measurements may inform future clinical trials and direct the development of embolic agents for bariatric embolization.

摘要

本研究旨在确定减肥栓塞中目标动脉的理想大小,目标是在保持患者安全的前提下最大程度地提高减肥效果。尽管所有已发表的减肥栓塞临床试验都使用了至少 300μm 直径的栓塞微球,但在使用 50μm 栓塞微球的情况下,在猪身上已安全实现了最佳的减肥效果。将减肥栓塞后猪胃底的残段与人类胃底手术后的残段进行比较,以评估减肥栓塞的理想胃底血管大小。在猪身上,50μm 的栓塞微球沉积在黏膜下层的腔内侧,平均小动脉大小为 49μm ± 30。人类胃底黏膜下层相应部位的小动脉直径为 40μm ± 30。这些测量结果可能为未来的临床试验提供信息,并指导减肥栓塞用栓塞剂的开发。

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Transcatheter Bariatric Embolotherapy for Weight Reduction in Obesity.经导管肥胖症减重栓塞疗法。
J Am Coll Cardiol. 2020 Nov 17;76(20):2305-2317. doi: 10.1016/j.jacc.2020.09.550.
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Gastric Embolization as Treatment for Overweight Patients; Efficacy and Safety.胃栓塞治疗超重患者:疗效与安全性
Cardiovasc Intervent Radiol. 2019 Apr;42(4):513-519. doi: 10.1007/s00270-018-2130-x. Epub 2018 Nov 28.

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