Clinical usefulness of technetium-99m-HMPAO-labeled leukocyte scan in prosthetic vascular graft infection.

作者：Mauro Liberatore, Anna Paola Iurilli, Fabio Ponzo, Daniela Prosperi, C. Santini, Pia Baiocchi, Luigi Rizzo, Francesco Speziale, P Fiorani, Antonio Centi Colella · 发表于：PubMed · 年份：1998 · 被引用次数：64 · 研究领域：Infectious Aortic and Vascular Conditions、Orthopedic Infections and Treatments、Aortic aneurysm repair treatments

UNLABELLED: 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 99mTc-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 in patients 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, wher...