The value of computed tomography angiography in evaluating autogenous arteriovenous fistula dysfunction in haemodialysis patients

Abstract

Introduction:

This study aimed to evaluate the diagnostic performance and clinical value of computed tomography angiography (CTA) in assessing postoperative restenosis of arteriovenous fistulas (AVFs), and to analyse the correlation between stenosis severity and post-intervention outcomes.

Methods:

This single-centre retrospective study included 102 patients (63% male; mean age: 59.2 years) with dysfunctional upper-limb autogenous arteriovenous fistulas undergoing haemodialysis, retrospectively analysed from April 2024 to February 2025. Computed tomography angiography-derived morphological parameters and prognostic data were collected.

Results:

In a diagnostic subset of 48 patients, CTA showed a sensitivity of 81%, specificity of 95% and overall accuracy of 88% for detecting ⩾50% stenosis compared with digital subtraction angiography (DSA). Moderate to severe stenosis (Grade 4–6) was found in 98% of cases, predominantly at the anastomotic site (83%). Thrombosis or collateral abnormalities occurred in 27% of cases. Balloon angioplasty was performed in 92%, restoring blood flow (400–600 mL/min) in 94%, with 86% achieving good functional recovery. Stenosis severity correlated with blood flow improvement (r = 0.253, p = 0.012) and functional recovery (r = 0.493, p = 0.029).

Conclusion:

Computed tomography angiography effectively assesses AVF stenosis and guides interventions, though its long-term prognostic value warrants further study.