Establishing a multidisciplinary bariatric arterial embolization program: A two-year clinical experience

Bariatric arterial embolization (BAE) is an emerging, minimally invasive, image-guided procedure for treating obesity in patients for whom nonoperative treatments have failed and metabolic-bariatric surgery is not an option. BAE has shown success in clinical studies, but guidance on integrating BAE into weight management programs (WMPs) is lacking. We describe our experience with building a multidisciplinary clinical program that integrates BAE into routine care for obesity.

We conducted a retrospective, single-center observational case series of patients treated with BAE through our WMP between November 2021 and September 2023. Patient chart review was performed for the following criteria for consideration of BAE: had a body mass index ≥30 kg/m², was unable to achieve weight and health goals through nonoperative management, and was ineligible or unwilling to undergo metabolic-bariatric surgery. Through multidisciplinary discussion, BAE was deemed suitable based on various patient-specific medical and technical reasons.

Thirty-one patients were considered for BAE through the program. Of those, 9 patients were cleared for BAE and 5 patients (4 women and 1 man) eventually underwent BAE. The mean age of the embolized patients was 42 years (range: 28-56). The mean pre-procedure weight was 116 kg (range: 100-134). Patients achieved a mean total body weight loss of 7.0% at 4-5 months' follow-up and 4.2% at 12 months. BAE was performed successfully with only transient nausea and vomiting postoperatively. The mean cost for BAE was $14,329 US dollars.

BAE offers an obesity treatment option with low complication risk and potential benefit when used as part of a comprehensive WMP. Close collaboration between interventional radiologists and obesity medicine physicians is key for success. BAE should be offered as a component within a comprehensive WMP rather than as a stand-alone procedure.