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RESULTS SMEs were reported by 38.4% of patients in the OLTP. Safety results from the OLTP were similar to those of the alirocumab group in the double-blind period, except for a lower rate of discontinuations due to SMEs observed with alirocumab in the OLTP (3.2% vs 15.9% in the double-blind period). At OLTP week 8, mean LDL-C reduction from baseline (=week 0 of double-blind period) was 52.0%, with reductions sustained through to the end-of-treatment visits (55.4% and 53.7% reduction at weeks 100 and 148, respectively). CONCLUSIONS In this population of statin-intolerant patients, alirocumab was well tolerated and produced durable LDL-C reductions over 3 years. The Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) in 2018 demonstrated the value of an omega-3 fatty acid formulation, icosapent ethyl (eicosapentaenoic acid ethyl ester) for preventive treatment of atherosclerotic cardiovascular disease (ASCVD). This JCL Roundtable discussion brings together three experts to explore the origins and implications of REDUCE-IT and more broadly omega-3 fatty acids for mitigation of ASCVD risk. REDUCE-IT achieved a highly significant 25% reduction of major adverse cardiovascular events. It is the first trial of a triglyceride-lowering drug to gain unequivocal success in high-risk patients treated intensively with statins. It corroborates positive results from an earlier major trial using eicosapentaenoic acid (EPA) ethyl ester, the Japan EPA Lipid Intervention Study (JELIS), which included hypercholesterolemic subjects treated with low-dose statin mostly in primary prevention. Together these studies mark a new avenue for preventive treatment of ASCVD. Omega-3 fatty acids also show some promise, though less decisively, for reducing inflammation and cardiovascular mortality in a broader context. The prevalence of obesity is increasing globally, leading to significantly increased morbidity, mortality, and health care costs. However, there is a lack of effective treatment options that can treat patients with obesity less invasively than with bariatric surgery. Bariatric arterial embolization (BAE) is an image-guided, minimally invasive, percutaneous procedure that is currently being investigated in preclinical animal models and early clinical trials. If successful, BAE may represent a viable interventional approach for obesity treatment. The purpose of this article is to introduce the physiological and anatomical rationale for BAE, review techniques involved in performing BAE for weight modulation, and provide up-to-date preclinical evidence that supports the translation of BAE into patients. There are a number of pathologic conditions in the human body that may be modified by the interruption of neural signaling, both related to pain and otherwise. Many of these treatments currently involve implantable neuromodulation or frank surgical neural ligation, representing opportunities for the implementation of percutaneous device-mediated cryoneurolysis in interventional radiology. Computed tomography-guided cryovagotomy for the management of mild to moderate obesity represents one such opportunity currently under investigation. read more This procedure is designed to attenuate hunger signals by targeting the posterior vagal trunk using computed tomography for cryoablation with a needle, based on historical surgical and electrical vagotomy experience. Future investigations of this technique and others will expand and iterate the concept of percutaneous, image-guided cryoneurolysis as potential management for a wide variety of clinical challenges. Aspiration therapy is a novel, endoscopic bariatric therapy that allows patients to remove a portion of an ingested meal through a modified percutaneous gastrostomy tube, called an A-Tube. Weight loss results from both fewer calories consumed, and from modifications in lifestyle and mealtime behaviors that patients make as a result of having the device installed. The first commercially available device for aspiration therapy, the AspireAssist (Aspire Bariatrics, King of Prussia, PA), was approved by the Food and Drug Administration in 2016 for weight loss for greater than 6 months duration in patients with a body mass index of 35-55. Multiple studies have demonstrated the effectiveness and safety of aspiration therapy, with low rates of adverse events related to the procedure, including no reported deaths, as well as no evidence of eating disorders developed during therapy. This chapter will describe our experience with aspiration therapy. We will describe how we select appropriate candidates for aspiration therapy, how we perform the procedure including a summary of the equipment used, and how we mitigate and manage complications of the procedure. This article will highlight the effectiveness of aspiration therapy as a novel and safe approach for weight loss in patients in obesity. Bariatric arterial embolization (BAE) is a novel technique that is investigated as an alternative, often supplementary, method for weight management. BAE reduces blood perfusion to the gastric fundus, and thus, reduces the production of appetite-inducing hormones. No randomized controlled trial has evaluated the efficacy of BAE to date. Available evidence from published studies include retrospective evaluations of patients undergoing left gastric artery embolization for gastrointestinal bleeding, and early prospective, single-arm clinical trials. Review of clinical data from human trials suggest an average weight loss of about 8-9 kg (ranging 7.6-22.0 kg), corresponding to 8-9% (ranging 4.8-17.2%) of the patients' baseline weight. Common complications include superficial gastric ulcers. Though uncommon, gastric perforation and splenic infarct are important major complication that may arise after left gastric artery embolization. Overall, BAE is an effective, relatively safe procedure that may be associated with clinically significant weight loss in patients with obesity. Obesity is a well-known major public health concern associated with significant morbidity and mortality. Bariatric arterial embolization (BAE) is a minimally invasive, image-guided therapy that targets hormones linked to obesity by defunctionalizing specific portions of the stomach with the delivery of embolics. The goal of BAE is to induce weight loss through a reduction of appetite-mediating hormones with transarterial embolization of the gastric fundus. This article will review the anatomical and technical considerations for successful BAE.