In Reply to: Case 0498_05 -- Renal transplant AV fistula detected only by CO2 arteriography posted by Editor on March 31, 1998 at 14:51:58:
We had a similar experience in a patient with blunt liver trauma; CO2 arteriography showed multiple small arterio-portal fistulas not seen on conventional arteriography. We decided against intervention, and the patient recovered uneventfully. The decision was arbitrary, based upon the assumption that without CO2 we have probably missed many small bleeds that seem not to have been clinicaly important.
The US was wise in your patient, as you now have a non-invasive means of following the AVF. The threshold fro intervention in a transplant kidney may be lower than other areas.