White blood cell scintigraphy in the diagnosis of infection of endovascular prostheses within the first month after implantation.
BACKGROUND
99mTc-HMPAO-labeled leukocyte scintigraphy (WBCs) is useful in the diagnosis of vascular graft infection. However, false positives can occur in the early postoperative period. There are no data concerning the usefulness of WBCs in detecting endovascular prosthesis infection during this period. The aim of our study was to assess the reliability of WBCs in the diagnosis of early infection after endovascular prosthesis implantation.


METHODS
23 patients treated with endovascular grafts were submitted to preoperative diagnostic screening and to 3 WBCs (1 week before, 1 week after, and 1 month after surgery). After the last WBCs, all patients underwent a 14-month follow-up (range 6-37 months, median 12 months).


RESULTS
Three patients died, at 3, 4 and 5 months after surgery respectively. At the end of the follow-up, the presence of infection was demonstrated in one patient. Of the 70 WBCs performed, 4 gave positive results. No positive scintigraphies were obtained in the preoperative period. A positive scintigraphy was found one week after surgery in a patient who showed lymphorrhage at the site of surgical access. In the same patient, the scintigraphic result returned to normal at 1-month scintigraphy. At 12-month follow-up the patient did not present signs of infection. Three positive scintigraphies were obtained in the same patient. In this patient clinical symptoms of graft infection became evident about 19 months after surgery. WBCs was repeated and showed extension of the infection. The infection was confirmed at surgery.


CONCLUSIONS
WBCs do not provide false-positives in the first month after endovascular prosthesis implantation.
Liberatore
Mauro
M
Nuclear Medicine Unit, Department of Radiological Sciences, University of Rome La Sapienza, Rome, Italy. maurlib@tin.it
Misuraca
Maria
M
Calandri
Enrico
E
Rizzo
Luigi
L
Speziale
Francesco
F
Iurilli
Anna Paola
AP
Anagnostou
Cristos
C
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001011:Aorta / Q000601:surgery; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000175:diagnosis*; D007958:Leukocyte Count; D007962:Leukocytes; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging*; D011860:Radiography, Abdominal; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime