Embolisation of simple PAVMs with high-volume detachable non-fibered coils: a 3-year follow-up study

PURPOSE: To determine pulmonary arteriovenous malformation (PAVM) persistence and safety of high-volume detachable non-fibred (HVDNF) coil embolisation of de novo simple PAVMs using computed tomography pulmonary angiography (CTPA) at 6-month and 3-year follow-up.

METHODS: This retrospective single-cohort study included patients who underwent embolisation of de novo simple PAVMs, exclusively with HVDNF coils, between January 2018 and January 2021. Primary endpoints were PAVM persistence at 6 months, cumulative persistence at 3 years and coil recanalisation at 6 months and 3 years. Secondary endpoints were technical success, safety, repeat embolisation and vein diameter reduction. Persistence and recanalisation were confirmed with digital subtraction angiography (DSA).

RESULTS: This study included 50 patients with 75 de novo PAVMs. PAVM persistence at 6 months was 13.2%; cumulative persistence at 3 years was 17.4%. Coil recanalisation was the persistence mechanism in 10.3% of the cases at 6 months; at 3 years, this was 13.0%. Technical success rate was 98.7%. There were no procedure- or PAVM-related serious adverse events. Repeat embolisation with HVDNF coils was performed in 4 PAVMs after 6 months and 5 PAVMs after 3 years. Mean vein diameter reduction was 38.3% (SD 29.4%) at 6 months and 44.6% (SD 36.5%) at 3 years.

CONCLUSIONS: HVDNF coils are safe to use for de novo PAVM embolisation, show an excellent technical success rate and are associated with acceptable 6-month and 3-year persistence and coil recanalisation rates.