Spiral computed tomographic angiography--a new technique for evaluation of vascular access in hemodialysis patients.

Spiral computed tomographic angiography (CTA), a new noninvasive imaging technique, was used to study 10 arteriovenous fistulas (AVF) in 9 hemodialysis patients. Digital subtraction angiography (DSA) was also performed as a gold standard for comparison. AVF stenosis was graded by a four-point scale: grade 0, well patency of supplying artery, anastomosis and drainage vein; grade 1, < 50% stenosis; grade 2, 50-70% stenosis; grade 3, 70-99% stenosis, and grade 4, total occlusion. We found CTA correlated closely to DSA in detecting both stenosis and dilatation of AVF and it spared all the shortcomings of DSA. CTA has the potential to be alternative for imaging of dialysis fistulas. Further studies will be performed to specify the role of CTA images in the assessment of the hemodialysis vascular access.