Related Experiment Video
Updated: May 15, 2026

Creating Radio-cephalic Arteriovenous Fistula in the Forearm with a Modified No-Touch Technique
Published on: April 1, 2022
4D-CT angiography differentiating arteriovenous fistula subtypes
Tim R Beijer1, Ewoud J van Dijk, Joost de Vries
1Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Objective And Methods:
In the diagnostic work-up of patients suspected of a dural arteriovenous fistula (dAVF), imaging has a key role in order to diagnose the dAVF, assess its bleeding risk and choose optimal treatment strategy. Digital subtraction angiography (DSA) is the gold standard for the most detailed image of a dAVF. Nowadays four-dimensional CT angiography (4D-CTA) could possibly be an additional first-line tool in the work-up of a patient suspected of a dAVF. We describe three cases clinically suspected of a dAVF which had a diagnostic work-up with 4D-CTA as well as DSA. We evaluated the angioarchitecture of the dAVF both on 4D-CTA and DSA, with emphasis on the patterns of venous drainage as this is important in assessing the bleeding risk of a dAVF.
Results And Conclusion:
4D-CTA identified the dAVF, revealed its angioarchitecture and correctly differentiated different patterns of venous drainage (Borden type I, II and III) as confirmed on DSA. Although DSA has the advantage of higher spatial and temporal resolution, 4D-CTA seems to be a new useful non-invasive tool in the diagnostic work-up of a patient suspected of a dAVF.
Related Concept Videos
Hemodialysis I: Introduction
Imaging Studies for Cardiovascular System V: CT
Imaging Studies VII: Vascular Imaging
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

