Catheter-directed gastric artery chemical embolization suppresses systemic ghrelin levels in porcine model

Purpose: To prospectively test, in a porcine model, the hypothesis that catheter-directed gastric artery chemical embolization (GACE) can result in suppression of systemic ghrelin levels and affect weight gain. Materials and This study, which had Animal Care and Use Committee Methods: approval, was performed in healthy, growing swine (weight range, 40-45 kg; n = 10). GACE was performed in five swine with the infusion of sodium morrhuate (125 (ig) selectively into the gastric arteries that supply the fundus. Five control animals underwent a sham procedure with 5 mL of saline. Weight and fasting plasma ghrelin levels were obtained in animals at baseline and in weeks 1-4. Statistical testing for substantial differences in ghrelin blood levels over time and between treated and untreated animals was performed by using a cross-sectional timeseries linear model with feasibility generalized least squares. Results: The pattern of the change in ghrelin levels over time was significantly different between control and treated animals (P < .004). In treated animals, ghrelin levels were significantly reduced at week 1 (mean, 664.1 pg/mL ± 103.1 [standard error of the mean], P < .02), week 2 (mean, 618.1 pg/mL ± 180.4, P < .001), week 3 (mean, 578.4 pg/mL ± 214.9, P < .001), and week 4 (mean, 876.6 pg/mL ± 228.6, P < .03) relative to baseline (mean, 1006.3 pg/mL ± 190.1). The percentage change in serum ghrelin values in swine treated with GACE decreased from baseline to -34%, -38.6%, -42.5%, and -12.9% during weeks 1- 4, respectively. In control swine, percentage change in serum ghrelin was -1.7%, -9.7%, +2.6%, and + 18.2% during weeks 1-4, respectively. At the end of 4 weeks, control swine continued to gain weight, with a 15.1% increase from their original weight, while the weight in swine treated with GACE plateaued at an increase of 7.8% from the original weight. Conclusion: Catheter-directed GACE can suppress the appetite hormone ghrelin and affect weight gain.