Pulmonary arteriovenous malformations (PAVMs) are abnormal vascular connections between the pulmonary arteries and veins, often leading to significant clinical complications such as hypoxemia, paradoxical embolism, and brain abscesses. Embolisation has become the primary therapeutic modality for managing symptomatic PAVMs, with advancements in both technique and technology improving patient outcomes. This review explores the latest innovations in embolisation therapies for PAVMs, emphasizing emerging techniques, devices, and strategies that have refined treatment efficacy and safety.
Recent progress includes the introduction of precisely targeted embolisation techniques, such as cone-beam computed tomography (CBCT) guidance and three-dimensional imaging, enabling more accurate identification and treatment of complex, multiple, or peripheral lesions. Additionally, vascular plugs and microcoils have demonstrated superior performance in terms of lower recurrence rates and more complete occlusion of feeding vessels compared to traditional devices. The use of endovascular navigation systems has further enhanced procedural success, allowing for better catheter manipulation in challenging anatomical conditions.
Advancements in patient selection and pre-procedural planning, driven by enhanced imaging modalities such as CT pulmonary angiography (CTPA) and contrast-enhanced ultrasound, have led to improved outcomes and reduced complications. Moreover, personalized approaches, including consideration of patient-specific risk factors like comorbidities and lesion location, are becoming integral to optimizing treatment protocols.
While the benefits of embolisation are well-documented, ongoing research continues to explore the long-term outcomes, including post-embolisation pulmonary function, recurrence rates, and quality of life improvements. This review highlights the evolving landscape of embolisation for PAVMs and underscores the importance of continued innovation in enhancing treatment strategies and patient care. This review aims to explore the ongoing advancements in embolisation techniques for PAVMs, emphasising the critical role of innovation in improving therapeutic approaches and patient outcomes.