Catheter-directed gastric artery chemical embolization for modulation of systemic ghrelin levels in a porcine model: Initial experience

Purpose: To prospectively test, in a porcine model, the hypothesis that use of catheter-directed gastric artery chemical embolization (GACE) can result in substantial suppression of systemic ghrelin levels. Materials and Methods: The institutional animal care and use committee approved this study. Adult healthy swine (40-45 kg, n = 8) were tested. GACE was performed by infusing morrhuate sodium selectively into the left gastric artery. Six swine (animals A-F) underwent left GACE by using a dose-escalating regimen of morrhuate sodium, whereas two control swine underwent a sham procedure. Weight and fasting plasma ghrelin levels were compared in swine at baseline and at weeks 1-4. At week 4, stomachs were excised and analyzed. Analysis of the change in ghrelin values and weight was performed with both paired t test and unpaired Student t test. Results: In control swine (n = 2), there was no significant difference in ghrelin values before (844.8 pg/mL ± 40 [standard deviation]) and after (997 pg/ml, ± 93) the procedure (P = .5). Swine that received a low dose of morrhuate sodium (animals A-D) showed a significant increase in serum ghrelin values from 683.7 pg/mL ± 241 to 1555.9 pg/mL ± 312 (P = .002). At a higher dose, the mean baseline ghrelin values decreased from 466 pg/mL to 187 pg/mL ± 162. Weight changes of +1.4% and +8.6% were seen in swine that underwent GACE and control swine, respectively. Histochemical staining showed preservation of overall tissue architecture and parietal cells. Conclusion: Use of GACE can result in increased or suppressed ghrelin levels.