Image-guided Bariatric Arterial Embolization (BAE) for the Treatment of Obesity
图像引导肥胖动脉栓塞术 (BAE) 治疗肥胖症
基本信息
- 批准号:8420946
- 负责人:
- 金额:$ 34.43万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2013
- 资助国家:美国
- 起止时间:2013-05-01 至 2017-04-30
- 项目状态:已结题
- 来源:
- 关键词:AcuteAddressAdverse effectsAffectAmericanAnatomyAnimal ModelAnimalsArchitectureArterial EmbolizationArteriesBariatricsBiliaryBlood VesselsBody Weight decreasedBody fatBody mass indexCathetersCellsClinicClinicalDataDesire for foodDevicesDiabetes MellitusDiagnostic radiologic examinationDiseaseEatingEffectivenessEndocrineEndocrine GlandsFamily suidaeFeelingFoodFundusGastric mucosaGoalsHealthHealthcareHeart DiseasesHormonesHumanHungerImageImaging TechniquesIncidenceInjection of therapeutic agentInjuryInterventionIntestinesLeftLeptinLifeLiverMaintenanceMalignant NeoplasmsMapsMethodsModelingMorbid ObesityNatureObesityOperative Surgical ProceduresOverweightPancreasPatientsPenetrationPerioperative complicationPharmaceutical PreparationsPhase I Clinical TrialsPrevalenceProceduresProductionRefluxResolutionRiskRisk FactorsRoentgen RaysRoleSafetySignal TransductionSpinal DiseasesSpleenStomachStructureSystemTechniquesTechnologyTestingTherapeutic AgentsTherapeutic EmbolizationTimeToxic effectTranslatingTranslationsUlcerUnited StatesVascular DiseasesWeightWeight Gaincancer therapycone-beam computed tomographycostenergy balancegastric arterygastric fundusghrelinglucagon-like peptideimage guided interventionimage guided therapyimprovedinstrumentationjoint stressminimally invasivenovelobesity treatmentpalliativepublic health relevancereconstructionsuccesstargeted deliverytyrosyltyrosine
项目摘要
DESCRIPTION (provided by applicant): Approximately 127 million (65%) Americans are overweight, obese, or morbidly obese, and the number of obese Americans is rising. Obesity negatively affects general health and has been attributed to an increasing incidence of diabetes, heart disease, vascular disease, joint stress, lumbar spine disorders, liver and biliary disease, and various cancers. Currently, there are no image-guided or percutaneous interventions or alternatives to the current invasive surgical techniques for the morbidly obese. Moreover, these surgical approaches have variable success rates, are highly invasive (requiring reconstruction of bowel), and can have significant complications. Thus, a critical need exists for minimally invasive bariatric procedures to reduce the perioperative complication rate and cost of bariatric therapy. A potent endogenous hunger stimulant, ghrelin, which is principally produced in the gastric fundus, has been a target for weight loss. No clinically viable, non-surgical approaches to modulate ghrelin production have been developed to-date. However, our group has manipulated ghrelin levels and altered weight gain via embolization of the arterial supply to the fundus of the stomach in pigs. Bariatric gastric Artery Embolization (BAE) is a complicated procedure as multiple vessels supply the stomach, and branches of these same vessels supply multiple other key structures, such as the spleen, pancreas, and liver. Thus, the risk of non-target embolization of these key structures as well as injury or ulceration to the gastric mucosa is a concern. Unlike embolic therapy for cancer which is primarily palliative, if successful BAE could allow patients to lose weight, lower risk factors for other diseases, and live long productiv lives. Thus, critical issues such as improved targeting, safety, and long term efficacy need to be further addressed in order to translate this procedure from the swine model into patients. In this
proposal, we will improve BAE using advances in technology including specialized injection devices, X-ray visible embolic beads, and state-of-the-art X-ray imaging systems in order to produce a more complete fundal embolization with fewer adverse effects from non-target embolization and mucosal damage. Through this we hope to achieve prolonged ghrelin suppression and sustained weight loss. Our Specific Aims include: 1) Improved targeting of the gastric fundus using X-ray visible embolic beads of varying sizes, cone beam CT, and an anti-reflux embolic catheter; 2) Improved safety of BAE by assessing the effect of gastroprotective medications; and 3) determining the long term safety and efficacy of optimized BAE to both suppress ghrelin and alter weight.
描述(由申请人提供):大约1.27亿(65%)美国人超重、肥胖或病态肥胖,而且肥胖美国人的数量还在上升。肥胖对整体健康造成负面影响,并被归因于糖尿病、心脏病、血管疾病、关节应激、腰椎疾病、肝脏和胆道疾病以及各种癌症的发病率增加。目前,对于病态肥胖者,还没有图像引导或经皮介入或替代现有侵入性外科技术的方法。此外,这些手术方式的成功率各不相同,具有高度侵袭性(需要重建肠道),并且可能会有严重的并发症。因此,迫切需要微创减肥手术,以减少围手术期并发症发生率和减肥治疗的成本。Ghrelin是一种有效的内源性饥饿刺激剂,主要在胃底产生,一直是减肥的目标。到目前为止,还没有临床上可行的非手术方法来调节Ghrelin的产生。然而,我们的团队已经操纵了胃促生长素水平,并通过栓塞猪胃底的动脉供应改变了体重增加。减肥胃动脉栓塞术(BAE)是一个复杂的过程,因为多条血管供应胃,而这些血管的分支供应多个其他关键结构,如脾、胰腺和肝脏。因此,这些关键结构的非靶点栓塞术以及对胃粘膜的损伤或溃疡的风险是一个令人担忧的问题。与主要是姑息治疗的癌症栓塞术不同,如果BAE成功,可以使患者减轻体重,降低其他疾病的风险因素,并延长寿命。因此,需要进一步解决诸如改善靶向性、安全性和长期有效性等关键问题,以便将这一过程从猪模型转化为患者。在这
在这项提议中,我们将利用先进的技术,包括专门的注射设备、X射线可见栓塞珠和最先进的X射线成像系统来改进BAE,以产生更完整的眼底栓塞,减少非靶点栓塞和粘膜损伤的不良影响。通过这种方法,我们希望达到长期抑制胃促生长素和持续减肥的目的。我们的具体目标包括:1)使用不同大小的X射线可见栓塞珠、锥束CT和抗反流栓塞管改善对胃底的靶向性;2)通过评估胃保护药物的效果来提高BAE的安全性;以及3)确定优化的BAE在抑制Ghrelin和改变体重方面的长期安全性和有效性。
项目成果
期刊论文数量(0)
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DARA L KRAITCHMAN其他文献
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{{ truncateString('DARA L KRAITCHMAN', 18)}}的其他基金
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10198263 - 财政年份:2021
- 资助金额:
$ 34.43万 - 项目类别:
MR-compatible Devices for the Diagnosis and Treatment of Cardiomyopathies
用于诊断和治疗心肌病的 MR 兼容设备
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- 资助金额:
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MR-compatible Devices for the Diagnosis and Treatment of Cardiomyopathies
用于诊断和治疗心肌病的 MR 兼容设备
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MRI-Guided Cryoablation and Imaging-Guided Intratumoral Delivery of STING Agonist Immunotherapy to Target Localized and Metastatic Canine Osteosarcoma
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- 批准号:
10375449 - 财政年份:2020
- 资助金额:
$ 34.43万 - 项目类别:
MRI-Guided Cryoablation and Imaging-Guided Intratumoral Delivery of STING Agonist Immunotherapy to Target Localized and Metastatic Canine Osteosarcoma
MRI 引导冷冻消融和成像引导 STING 激动剂肿瘤内递送免疫疗法治疗局部和转移性犬骨肉瘤
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10633064 - 财政年份:2020
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MRI-Guided Cryoablation and Imaging-Guided Intratumoral Delivery of STING Agonist Immunotherapy to Target Localized and Metastatic Canine Osteosarcoma
MRI 引导冷冻消融和成像引导 STING 激动剂肿瘤内递送免疫疗法治疗局部和转移性犬骨肉瘤
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9980073 - 财政年份:2020
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Image-guided Bariatric Arterial Embolization (BAE) for the Treatment of Obesity
图像引导肥胖动脉栓塞术 (BAE) 治疗肥胖症
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8840587 - 财政年份:2013
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$ 34.43万 - 项目类别:
Image-guided Bariatric Arterial Embolization (BAE) for the Treatment of Obesity
图像引导肥胖动脉栓塞术 (BAE) 治疗肥胖症
- 批准号:
10593586 - 财政年份:2013
- 资助金额:
$ 34.43万 - 项目类别:
Image-guided Bariatric Arterial Embolization (BAE) for the Treatment of Obesity
图像引导肥胖动脉栓塞术 (BAE) 治疗肥胖症
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9061405 - 财政年份:2013
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$ 34.43万 - 项目类别:
Image-guided Bariatric Arterial Embolization (BAE) for the Treatment of Obesity
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- 批准号:
8651916 - 财政年份:2013
- 资助金额:
$ 34.43万 - 项目类别:
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