HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Liberatore, M. Articles by Colella, A. C. Search for Related Content PubMed PubMed Citation Articles by Liberatore, M. Articles by Colella, A. C.

Clinical Usefulness of Technetium-99m-HMPAO-Labeled Leukocyte Scan in Prosthetic Vascular Graft Infection

Department of Experimental Medicine and Pathology, Section of Nuclear Medicine, Rome Italy Department of Clinical Medicine, Department of Vascular Surgery, University of Rome La Sapienza, Rome Italy

Correspondence:

ABSTRACT

The infection of a prosthetic vascular graft (PVGI), although rare, is the most severe complication in reconstructive vascular surgery. The early diagnosis of this complication reduces the death rate from surgery. Aortofemoral graft infections differ clinically from peripheral graft infections in significant ways. The aim of this article is to evaluate separately the reliability of the ⁹⁹Tc-HMPAO-labeled leukocyte scan or white blood cell count (WBC) in the early detection of both aortofemoral and peripheral graft infections. Methods: One hundred sixty-two WBCs were performed on 129 consecutive patients with suspected aortofemoral (122 scans) and peripheral (40 scans) graft infection and in a 12-patient control group. Patients with suspected PVGI were categorized into three groups on the basis of their signs and symptoms on readmission: (a) patients with specific signs of graft infection (Group A); (b) patients with nonspecific signs of graft infection (Group B); and (c) patients with anastomotic aneurysms (Group C). Gram's stains of the perigraft exudate and graft cultures were performed and used as the gold standard inpatients who underwent surgery. An 18-mo clinical follow-up was done to assess the presence or absence of graft infection in patients who did not have surgery. Results: In patients with suspected aortofemoral graft infections, the overall sensitivity, specificity and accuracy of WBCs (Groups A,B,C) were 100%, 92.5% and 97.5%, respectively, whereas sensitivity, specificity and accuracy calculated in the patients with nonspecific signs of graft infection (Groups B,C) were 100%, 92.3% and 96.9%, respectively. In patients with suspected peripheral graft infections, sensitivity, specificity and accuracy were 100%. Conclusion: The white blood cell scan seems areliable diagnostic method for early diagnosis of PVGI, and it is more useful in aortofemoral graft infections.

Key Words: vascular graft • infection • technetium-99m-HMPAO-labeled leukocyte scan

This article has been cited by other articles:

				Z. Keidar, A. Engel, A. Hoffman, O. Israel, and S. Nitecki Prosthetic Vascular Graft Infection: The Role of 18F-FDG PET/CT J. Nucl. Med., August 1, 2007; 48(8): 1230 - 1236. [Abstract] [Full Text] [PDF]

				S. F. FitzGerald, C. Kelly, and H. Humphreys Diagnosis and treatment of prosthetic aortic graft infections: confusion and inconsistency in the absence of evidence or consensus J. Antimicrob. Chemother., December 1, 2005; 56(6): 996 - 999. [Abstract] [Full Text] [PDF]

				G. Illuminati, F. G. Calio, A. D'Urso, D. Giacobbi, V. Papaspyropoulos, and G. Ceccanei Infrascrotal, Perineal, Femorofemoral Bypass for Arterial Graft Infection at the Groin Arch Surg, December 1, 2004; 139(12): 1314 - 1319. [Abstract] [Full Text] [PDF]