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Peer-reviewedCC BYRenal failure

Bilateral peripheral CT venography for evaluating central venous lesions in dysfunctional arteriovenous fistulas: feasibility, safety, and radiation dose in hemodialysis patients.

  • Hongwei Zhang1
  • Hongming Liu1
  • Zhi Zou1
  • Shunqiang Chen1
  • Lili Shi1
  • Yongli Li1
  • Shewei Dou1
  1. 1Department of Medical Imaging, Henan Provincial People's Hospital, Zhengzhou, China.
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Abstract

Objectives

Central venous stenosis and occlusion are major causes of arteriovenous fistula (AVF) dysfunction in hemodialysis patients. This study aimed to evaluate the feasibility, safety, radiation exposure, and anatomical findings of bilateral peripheral CT venography for central venous assessment in patients with dysfunctional AVFs.Methods

This single-center retrospective cohort study included 46 consecutive hemodialysis patients with dysfunctional AVFs who underwent bilateral peripheral CT venography between August 2023 and June 2025. Technical success, procedure-related adverse events, radiation dose parameters, central venous lesion characteristics, and agreement with available comparative imaging modalities were analyzed. Comparative imaging findings from puncture-based angiography and/or duplex ultrasonography were assessed descriptively.Results

All 46 examinations were technically successful (100%), with a mean procedure duration of 4 minutes (range, 3-5 minutes). Minor adverse events included one patient of contrast extravasation (2.2%) and 3 of mild allergic reactions (6.5%); no severe procedure-related complications were documented. The mean CTDIvol and DLP were 11.87 mGy and 784.15 mGy·cm, respectively. Central venous abnormalities were identified in 44 patients (95.7%), including stenosis in 31 (67.4%), occlusion in 11 (23.9%), and aneurysmal changes in 2 (4.3%). Comparative imaging was available in 38 patients, and CT venography showed agreement with available findings in 37 cases (97.4%). This agreement was interpreted as descriptive concordance rather than formal diagnostic accuracy.Conclusions

Bilateral peripheral CT venography demonstrated high technical feasibility, acceptable safety, and effective visualization of central venous abnormalities in hemodialysis patients with dysfunctional AVFs. Further prospective studies are needed to validate its diagnostic performance and clinical impact.Advances in knowledge

This technique enables efficient, noninvasive assessment of central venous pathology with minimal risk, supporting its potential as a practical alternative to conventional imaging in hemodialysis patients.

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Cite

BibTeXRIS
BibTeX
@article{zhang2026bilateral,
  title = {{Bilateral peripheral CT venography for evaluating central venous lesions in dysfunctional arteriovenous fistulas: feasibility, safety, and radiation dose in hemodialysis patients.}},
  author = {Hongwei Zhang and Hongming Liu and Zhi Zou and Shunqiang Chen and Lili Shi and Yongli Li and Shewei Dou},
  journal = {Renal failure},
  year = {2026},
  month = oct,
  doi = {10.1080/0886022x.2026.2740365},
  url = {https://europepmc.org/article/MED/42902599},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Bilateral peripheral CT venography for evaluating central venous lesions in dysfunctional arteriovenous fistulas: feasibility, safety, and radiation dose in hemodialysis patients.
AU  - Hongwei Zhang
AU  - Hongming Liu
AU  - Zhi Zou
AU  - Shunqiang Chen
AU  - Lili Shi
AU  - Yongli Li
AU  - Shewei Dou
PY  - 2026
DA  - 2026/10/20
JO  - Renal failure
DO  - 10.1080/0886022x.2026.2740365
UR  - https://europepmc.org/article/MED/42902599
AB  - Objectives  Central venous stenosis and occlusion are major causes of arteriovenous fistula (AVF) dysfunction in hemodialysis patients. This study aimed to evaluate the feasibility, safety, radiation exposure, and anatomical findings of bilateral peripheral CT venography for central venous assessment in patients with dysfunctional AVFs.Methods  This single-center retrospective cohort study included 46 consecutive hemodialysis patients with dysfunctional AVFs who underwent bilateral peripheral CT venography between August 2023 and June 2025. Technical success, procedure-related adverse events, radiation dose parameters, central venous lesion characteristics, and agreement with available comparative imaging modalities were analyzed. Comparative imaging findings from puncture-based angiography and/or duplex ultrasonography were assessed descriptively.Results  All 46 examinations were technically successful (100%), with a mean procedure duration of 4 minutes (range, 3-5 minutes). Minor adverse events included one patient of contrast extravasation (2.2%) and 3 of mild allergic reactions (6.5%); no severe procedure-related complications were documented. The mean CTDIvol and DLP were 11.87 mGy and 784.15 mGy·cm, respectively. Central venous abnormalities were identified in 44 patients (95.7%), including stenosis in 31 (67.4%), occlusion in 11 (23.9%), and aneurysmal changes in 2 (4.3%). Comparative imaging was available in 38 patients, and CT venography showed agreement with available findings in 37 cases (97.4%). This agreement was interpreted as descriptive concordance rather than formal diagnostic accuracy.Conclusions  Bilateral peripheral CT venography demonstrated high technical feasibility, acceptable safety, and effective visualization of central venous abnormalities in hemodialysis patients with dysfunctional AVFs. Further prospective studies are needed to validate its diagnostic performance and clinical impact.Advances in knowledge  This technique enables efficient, noninvasive assessment of central venous pathology with minimal risk, supporting its potential as a practical alternative to conventional imaging in hemodialysis patients.
SN  - 0886-022X
SN  - 1525-6049
ER  -