Left Gastric Artery Embolization for Obesity and Glycemic Control: Three-year Clinical Outcomes

Abstract Objectives: To evaluate the long-term efficacy of left gastric artery embolization (LGAE) for sustained weight loss and glycemic control in obese, prediabetic patients over 3 years. Materials and Methods: Ten obese, prediabetic patients (7 women, 3 men; mean age, 37.52 ± 8.76 years) from our initial pilot study were followed prospectively for 3 years after undergoing LGAE. The procedure was performed by three experienced interventional radiologists using 300–500 μm microspheres to selectively embolize the left gastric artery. Clinical parameters, including weight, body mass index (BMI), and glycated hemoglobin (HbA1c), were measured at baseline and subsequently at 6-month intervals. Clinical success was defined as sustained weight loss (≥10%) and glycemic improvement. Correlation analysis and multivariate regression models were performed to identify predictive factors for long-term outcomes. Results: At 6 months, significant reductions in weight (8.87% ± 1.23%), BMI (8.82% ± 1.04%), and HbA1c (21.42% ± 8.86%, P < 0.001) were observed. Two patients underwent sleeve gastrectomy after 1 year and were excluded from long-term analysis. Among the remaining eight patients, weight loss peaked at 24 months (14.04% ± 1.79%), followed by a slight increase at 36 months (10.82% ± 1.90%, P = 0.089). HbA1c levels showed a sustained improvement, decreasing to 5.48% ± 0.42% at 36 months (8.32% reduction, P = 0.082). Baseline BMI and early HbA1c response at 6 months were significant predictors of long-term weight loss and glycemic maintenance. Conclusion: LGAE demonstrates significant early benefits in weight loss and glycemic control. While weight loss effects gradually diminish over 3 years, glycemic improvement is maintained below the prediabetic threshold, suggesting LGAE’s potential role in long-term metabolic improvement.