Percutaneous CT‐Guided Cryovagotomy in Patients with Class I or Class II Obesity: A Pilot Trial

Abstract

Objective: This study evaluated the safety of percutaneous CT-guided cryoablation of the vagus nerve (percutaneous cryovagotomy) in participants with class I or class II obesity. Methods: The study was an open-label, single-group, prospective pilot investigation designed around safetyrelated stopping criteria. Twenty participants with 30 > BMI > 37 underwent percutaneous cryovagotomy with follow-up visits at day 7, 45, 90, and 180. Data related to adverse events, technical success, weight loss, quality of life, dietary intake, global impressions of hunger change, activity, and body composition were analyzed. Results: The procedural technical success rate was 100%. There were no adverse events in 19 participants who completed the trial. Ninety-five percent of patients reported decreased appetite following the procedure, and reductions in mean absolute weight and BMI were observed at all time points. The mean quality of life and activity scores improved from baseline to 6 months post procedure, and mean caloric intake and overall body fat decreased over the same period. Conclusions: Percutaneous CT-guided cryovagotomy is feasible and was tolerated without complications or adverse events in this cohort. Quantitative preliminary data from this pilot investigation inform the design of a larger prospective randomized clinical trial.

Decoding Vagus-Nerve Activity with Carbon Nanotube Sensors in Freely Moving Rodents

“…Vagus-nerve stimulation has been used to treat a wide variety of diseases [ 6 ], most successfully implemented for the treatment of epilepsy [ 7 ], even while the mechanisms are not well understood and direct recordings of vagal activity associated with disease are not available [ 8 ]. The majority of vagal afferent fibers come from the gut [ 9 , 10 ], and abnormal vagal activity has been clearly implicated in eating and metabolic disorders [ 11 , 12 , 13 , 14 , 15 ]. In this study, we analyze the first chronic recordings of vagal spikes and the correlation of signals to several behaviors in healthy rats.…”

Bioelectronic medicine for the autonomic nervous system: clinical applications and perspectives

“…In addition to the electrical modulation of the abdominal VN, the pilot study by Prologo et al is also noteworthy and showed the feasibility of percutaneous CT-guided cryovagotomy and its effectiveness in improving the mean quality of life and activity scores in class I-II obese subjects [130].…”

Postoperative and Long-Term Endocrinologic Complications of Craniopharyngioma

“…Surgical vagotomy might effectively limit insulin secretion and induce weight loss; however, large-scale studies are missing in that respect [99]. In a pilot open-label study of percutaneous CT-guided cryovagotomy in individuals with BMI >30, 95%, the patients reported decreased appetite following the procedure, and reductions in mean absolute weight and BMI were observed at all time points up to 180 days [100].…”