ArticleRenal failure2026
Predicting computed tomography angiography-measured arteriovenous fistula anastomosis angles using intraoperative non-contrast measurements: a prospective validation study.
Article in Renal failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundThe anastomotic angle is a modifiable determinant of arteriovenous fistula (AVF) hemodynamics, maturation, and patency. Postoperative assessment typically relies on computed tomography angiography (CTA); however, factors such as contrast exposure, radiation, and cost limit its utility for repeated evaluations. In this study, we derived a correction factor for CTA-measured anastomotic angles. The primary aim was to validate the measurement method, rather than to establish a direct link between the angle and clinical outcomes.
methodsThis study collected intraoperative measurements from patients undergoing AVF surgeries and used these data to construct a predictive model for CTA-measured anastomosis angles. The model was validated using 20% of the data, with the remaining data used for model fitting. Bootstrap resampling (1,000 samples) was employed to estimate the mean squared error (MSE) and confidence intervals.
resultsThe Bland-Altman plot indicated a mean difference of -16.90 between CTA and intraoperative measurements, with the majority of data points falling within the 95% limits of agreement. The Intraclass Correlation Coefficient was 0.79, suggesting acceptable reliability despite notable bias, while the Concordance Correlation Coefficient was 0.45, reflecting the impact of bias. Bootstrap validation yielded a mean MSE of 24.58 with a standard deviation of 15.17. The 95% percentile confidence interval was [2.66, 51.85].
conclusionThis study provides a preliminary adjustment estimate to bridge the gap between intraoperative and CTA-measured angles. While not a fully developed predictive framework, this correction factor offers a practical, radiation-free method for surgeons to approximate the final anastomotic configuration.
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