Percutaneous CT-Guided Cryovagotomy Studied to Treat Obesity

March 28, 2018—Freezing the nerve that carries hunger signals to the brain may help patients with mild-to-moderate obesity lose weight, according to a study presented at SIR 2018, the Society of Interventional Radiology’s annual scientific meeting held March 17–22 in Los Angeles, California.

The procedure was determined to be safe and feasible in the initial pilot phase of the study, which was funded by HealthTronics, the manufacturer of the ablation probes used for the treatment.

During the procedure, an interventional radiologist inserts a needle through the patient’s back and, guided by live images from a CT scan, uses argon gas to freeze the nerve—the posterior vagal trunk located at the base of the esophagus. This nerve is one of several mechanisms that communicates with the brain to indicate that the stomach is empty.

As explained in the SIR press release, the study was composed of 10 patients with a body mass index (BMI) between 30 and 37 who underwent the procedure and were followed for 90 days. All patients reported decreased appetite and the overall average weight loss was 3.6% of initial body weight and an average decline of nearly 14% of the excess BMI. No procedure-related complications were reported, and there were no adverse events during the follow-up.

After the success of this preliminary safety and feasibility study, more patients are being recruited for a larger clinical trial of the procedure to test the efficacy and durability of the procedure. In presenting the study, the authors note several limitations, including the small sample size and the interim nature of the results.

The study, "Percutaneous CT-Guided Cryovagotomy for the Management of Mild-to-Moderate Obesity: A Pilot Trial," was led by David Prologo, MD, an interventional radiologist with Emory University School of Medicine in Atlanta, Georgia. The study (abstract 2186) is available online at sirmeeting.org.

In the SIR announcement, Dr. Prologo commented, "We developed this treatment for patients with mild-to-moderate obesity to reduce the attrition that is common with weight loss efforts. We are trying to help people succeed with their own attempts to lose weight.”

He added, “Medical literature shows the vast majority of weight loss programs fail, especially when people attempt to reduce their food intake. When our stomachs are empty, the body senses this and switches to food-seeking survival mode. We’re not trying to eliminate this biological response, only reduce the strength of this signal to the brain to provide a new, sustainable solution to the difficult problem of treating mild obesity.”