Intravascular ultrasound diagnosis of aortic graft infection.
BACKGROUND
To assess the value of intra-aortic ultrasound (US) for diagnosing intraprosthetic vegetations in atypical aortic graft infection.


METHODS
A 66-year-old man presented with fever 12 months after emergency insertion of a straight infrarenal aortic graft because of rupture of an inflammatory abdominal aneurysm. Blood cultures, leukocyte scan, transabdominal US study, and digital angiography were negative. Spiral CT was equivocal. The patient was imaged with a mechanically rotating US transducer at 12.5-MHz from inside the graft.


RESULTS
Intravascular catheter ultrasound showed mobile lesions at the graft wall in the absence of periprosthetic fluid. Immediately after the procedure the patient developed several small cutaneous septic infarctions on both feet. At operation the presence of graft infection was confirmed.


CONCLUSIONS
This case report suggests that intra-aortic US may constitute a helpful adjunctive modality in suspected atypical infection of prosthetic aortic grafts.
Duda
S H
SH
Department of Radiology, Eberhard-Karls-Universität Tübingen, Germany.
Schott
U
U
Raygrotzki
S
S
D000368:Aged; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D004927:Escherichia coli Infections / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging*; D011512:Proteus Infections / Q000000981:diagnostic imaging*; D011514:Proteus vulgaris; D018084:Ultrasonography, Interventional