Document resource
Introduction and Objectives Embolisation represents the primary therapeutic intervention for pulmonary arteriovenous malformations (PAVMs); however, post-procedural recanalisation remains a recognised complication. This study aimed to identify potential risk factors associated with recanalisation following PAVM embolisation at a tertiary referral centre.Methods A retrospective, single-centre, 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 size on follow-up CT angiography) were collected. Univariate 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. Recanalisation was significantly associated with male gender (odds ratio [OR] 3.52, p = 0.018), larger feeding artery diameter (OR 1.410, p = 0.008), greater sac diameter (OR 1.052, p = 0.022), and complex PAVM morphology (OR 5.464, p = 0.002). 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]).Conclusions Male gender, larger feeding artery diameter, sac dimensions, and complex PAVM morphology were associated with an increased risk of recanalisation. Coil-only embolisation demonstrated a non-significant trend toward higher recanalisation rates. Larger, prospective studies are needed to validate these findings and optimise embolisation strategies.