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Purpose <p>Embolisation represents the primary therapeutic intervention for pulmonary arteriovenous malformations (PAVMs); however, post-procedural recanalisation remains a recognised complication. This study aimed to identify anatomical and morphological factors associated with PAVM recanalisation, while also describing embolisation modalities used.</p> Methods <p>A retrospective, observational analysis was conducted on 40 patients with PAVMs embolised. Demographic variables, angiographic measurements (supplying artery, vein, sac diameters), embolisation modalities including coils, Amplatzer vascular plugs (AVPs), microvascular plugs (MVPs), or combinations, and the presence of recanalisation (defined as &lt; 70% reduction in linear sac diameter on follow-up CT angiography) were collected. Logistic regression analysis was performed.</p> Results <p>A total of 109 pulmonary arteriovenous malformations (PAVMs) were embolised across 40 patients, with follow-up imaging available for 86 PAVMs. Larger feeding artery diameter (OR 1.410, <i>p</i> = 0.008) and complex PAVM morphology (OR 5.464, <i>p</i> = 0.002) were significantly associated with recanalisation on univariate analysis. Male sex and greater sac diameter were also associated on univariate analysis but did not remain significant in the multivariable model. On multivariable logistic regression, complex PAVM morphology (OR 4.00, 95% CI 1.27–12.66, <i>p</i> = 0.018) and larger feeding artery diameter (OR 1.29 per mm, 95% CI 1.01–1.65, <i>p</i> = 0.044) were independently associated with recanalisation. Although not reaching statistical significance, there was a trend toward higher recanalisation rates in lesions treated with coil embolisation (OR 1.926, <i>p</i> = 0.166). Embolisation with vascular plugs was associated with less risk of recanalisation but was insignificant (AVP [OR 0.782, <i>p</i> = 0.654], MVP [OR 0.342, <i>p</i> = 0.078]).</p> Conclusion <p>Larger feeding artery diameter and complex PAVM morphology were independently associated with recanalisation on multivariable analysis. Male sex showed a univariable association that did not persist after adjustment and should be considered exploratory. Device type showed trends but was not&#xa0;a primary determinant. Larger, prospective studies are needed to validate these findings and optimise embolisation strategies.</p>

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Anatomical and morphological predictors of pulmonary arteriovenous malformation recanalisation following embolisation: a retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月5日

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  • Chai Jin Lim,
  • Ahmad Barotchi,
  • Yousef Shahin

摘要

Purpose

Embolisation represents the primary therapeutic intervention for pulmonary arteriovenous malformations (PAVMs); however, post-procedural recanalisation remains a recognised complication. This study aimed to identify anatomical and morphological factors associated with PAVM recanalisation, while also describing embolisation modalities used.

Methods

A retrospective, observational analysis was conducted on 40 patients with PAVMs embolised. Demographic variables, angiographic measurements (supplying artery, vein, sac diameters), embolisation modalities including coils, Amplatzer vascular plugs (AVPs), microvascular plugs (MVPs), or combinations, and the presence of recanalisation (defined as < 70% reduction in linear sac diameter on follow-up CT angiography) were collected. Logistic regression analysis was performed.

Results

A total of 109 pulmonary arteriovenous malformations (PAVMs) were embolised across 40 patients, with follow-up imaging available for 86 PAVMs. Larger feeding artery diameter (OR 1.410, p = 0.008) and complex PAVM morphology (OR 5.464, p = 0.002) were significantly associated with recanalisation on univariate analysis. Male sex and greater sac diameter were also associated on univariate analysis but did not remain significant in the multivariable model. On multivariable logistic regression, complex PAVM morphology (OR 4.00, 95% CI 1.27–12.66, p = 0.018) and larger feeding artery diameter (OR 1.29 per mm, 95% CI 1.01–1.65, p = 0.044) were independently associated with recanalisation. Although not reaching statistical significance, there was a trend toward higher recanalisation rates in lesions treated with coil embolisation (OR 1.926, p = 0.166). Embolisation with vascular plugs was associated with less risk of recanalisation but was insignificant (AVP [OR 0.782, p = 0.654], MVP [OR 0.342, p = 0.078]).

Conclusion

Larger feeding artery diameter and complex PAVM morphology were independently associated with recanalisation on multivariable analysis. Male sex showed a univariable association that did not persist after adjustment and should be considered exploratory. Device type showed trends but was not a primary determinant. Larger, prospective studies are needed to validate these findings and optimise embolisation strategies.