technetium-tc-99m-exametazime and Aortic-Aneurysm--Abdominal

To compare F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG-PET) and (99m)Tc-hexamethylpropylene amine oxime ((99m)TC-HMPAO) labelled leukocyte scintigraphy for the diagnosis of vascular graft infection. A thoraco-abdominal CT-angiography and a (99m)TC-HMPAO labelled leukocyte scintigraphy did not show any graft infection in this case report whereas an F-18 FDG-PET showed a metabolic uptake around and all along the vascular graft. Further comparison between these two explorations is needed since the two techniques have not been compared in vascular graft infection.

Topics: Aortic Aneurysm, Abdominal; Aortography; Behcet Syndrome; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Community Mental Health Services; Device Removal; Fluorodeoxyglucose F18; Humans; Leukocytes; Male; Middle Aged; Positron-Emission Tomography; Predictive Value of Tests; Prosthesis-Related Infections; Radiopharmaceuticals; Reoperation; Staphylococcus aureus; Technetium Tc 99m Exametazime; Tomography, X-Ray Computed

Topics: Aged; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis; Humans; Leukocytes; Male; Prosthesis-Related Infections; Radionuclide Imaging; Stents; Technetium Tc 99m Exametazime

Topics: Aged; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Aortic Diseases; Blood Vessel Prosthesis; Duodenal Diseases; Humans; Intestinal Fistula; Leukocytes; Male; Prosthesis-Related Infections; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Vascular Fistula

This study was performed to evaluate the utility of Tc-99m HMPAO-labeled leukocyte total-body scans (TBLS) for detecting remote septic foci before operation in patients undergoing aortofemoral vascular surgery.. Fifty-eight patients were screened before operation for inflammatory or infective disease, and a clinical score was assigned to each patient. Each patient had TBLSs. The relation between the clinical score and the TBLS result was determined. Patients with positive results of the TBLSs were examined, and the causes of these findings were treated before surgery.. Ten of the 58 (17%) patients had a positive result of TBLSs. Of 31 patients with a clinical score of zero, 3 had positive findings of TBLS. No TBLS was positive in the 13 patients with a clinical score of 1. TBLS findings were positive in 7 of 14 of the combined patients with clinical scores of 2, 3, or 4. None of the patients showed signs of prosthetic vascular graft infection during the postoperative follow-up period.. In conclusion, TBLSs can be used before aortofemoral vascular surgery, but only in patients with high clinical scores for inflammatory or infective disease to identify relevant infective foci that could cause vascular graft infection.

Topics: Aged; Aortic Aneurysm, Abdominal; Aortic Aneurysm, Thoracic; Blood Vessel Prosthesis Implantation; Female; Humans; Leukocytes; Male; Preoperative Care; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Exametazime

Topics: Aged; Aneurysm, False; Aortic Aneurysm, Abdominal; Arteritis; Blood Vessel Prosthesis; Diagnosis, Differential; Erythrocytes; Femoral Artery; Humans; Iliac Artery; Leukocytes; Male; Postoperative Complications; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Exametazime

Aortic graft infection may result in high mortality ranging up to 88%. Therefore, early diagnosis is imperative in the treatment of this serious complication. Computerised tomography (CT) is considered as a sensitive tool in the diagnosis of aortic graft infection. Some findings used as the criteria for infection, such as periprosthetic gas and fluid are, however, normal postoperative findings. The aim of this prospective study was to compare CT-scan and Tc-99m-HMPAO labelled leucocytes in the early diagnosis of aortic graft infection. The present study includes 24 consecutive patients (all men, age 70 +/- 8 years, range 55-85 years), who were operated on for abdominal aortic aneurysm. Prosthetic and suture materials were the same in all operations. Each patient was examined with the aid of CT-scan and imaged with Tc-99m-HMPAO labelled leucocytes 2 weeks and 3, 6 and 12 months after the reconstructive aortic surgery. Two radiologists and two specialists in nuclear medicine examined the data independently without knowing the clinical picture of the results of any other examinations of the patients. Seven patients (7/24; 29%) showed significant accumulation of labelled leucocytes in the first imaging (2 weeks postoperatively) with Tc-99m-HMPAO labelled leucocytes. Three months after the surgery only four patients (4/24; 17%) were positive in this respect. One of these patients had clinically proven aortic graft infection and another positive was a patient with resected and reconstructed mycotic aneurysm. CT-examination in all scans was suggestive for aortic graft infection in two cases (2/24; 8%), but neither of these patients showed any signs of infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Aged, 80 and over; Aortic Aneurysm, Abdominal; Blood Vessel Prosthesis; Diagnostic Imaging; Femoral Artery; Follow-Up Studies; Graft Occlusion, Vascular; Humans; Iliac Artery; Leukocytes; Male; Middle Aged; Organotechnetium Compounds; Oximes; Polyethylene Terephthalates; Postoperative Complications; Prospective Studies; Staphylococcal Infections; Surgical Wound Infection; Technetium Tc 99m Exametazime; Tomography, X-Ray Computed; Wound Healing