Computed tomography assessment of the gastric arterial anatomy for embolisation treatment of obesity.

BACKGROUND

Obesity is a global pandemic affecting more than 1 billion people worldwide and a leading cause of preventable death. Left gastric artery embolisation to inhibit ghrelin secretion, a hormonal driver of appetite, has been proposed as a potentially safer treatment for obesity than surgery. This study describes the incidence of anatomical variation, gastric artery anastomoses, collateral supply and vessel lengths, diameters and angles of origin relevant to embolisation of the LGA in the EMBIO cohort of obese patients.

RESULTS

Arterial phase CT scans (n = 90) were performed as part of screening for the EMBIO trial. 62 participants (69%) had conventional coeliac and hepatic artery anatomy. 14 participants (16%) had left hepatic arterial supply originating from the LGA. The most common LGA branching pattern (37%) was for the first branch to supply the cardia / gastro-oesophageal junction and then for the LGA to split into two main branches supplying the gastric fundus. 34% had a left- right gastric artery anastomosis visible on CT. The LGA was the dominant artery supplying the gastric fundus in 51% with supply from multiple arteries, most frequently the LGA and short gastric arteries (27%), seen in the other participants.

CONCLUSION

This study presents detailed analysis of the arterial anatomy relevant to performing successful and safe embolisation of the LGA for treatment of obesity and acute haemorrhage.