The number of overweight and obese individuals has increased dramatically in the last 20 years, suggesting that current medical and surgical therapeutic options for the bariatric patient are limited. Ghrelin, a hormone primarily produced by the epithelium of the gastric fundus, is the only known appetite-stimulating hormone. Studies in animal models have shown that catheter-directed, trans-arterial embolization of the left gastric artery, which preferentially supplies the gastric fundus, can suppress ghrelin production and modulate body weight. Investigations into left gastric artery embolization as a mechanism for weight loss in patients are nascent. This chapter will briefly outline the gastrointestinal tract’s endocrine function in metabolic homeostasis, explain the rationale in targeting ghrelin to induce weight loss, describe the technical aspects of left gastric artery embolization, and review the studies evaluating the left gastric artery embolization as a means to treat obesity.
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