The role of Positron Emission Tomography in diagnosis of vascular prosthetic graft infections

Objective: Vascular prosthetic graft infections can be fatal, especially if it involves the intra-abdominal region. Definitive treatment is the removal of the infected graft and administration of appropriate antibiotic therapy. Removal of the prosthetic graft causes the problem of blood supply leading the extremity to ischemia. For this reason, it is important to decide whether the infected graft would be removed. We aimed to evaluate the role and efficiency of positron emission tomography (PET) for the diagnosis of vascular prosthetic graft infections. Materials and Methods: Between May 2013 and January 2015, eight patients were diagnosed with graft infection. They were assessed with PET. All the patients were male, and the average age was 52 ± 7. PET-computed tomography was performed following 4 weeks of antibiotherapy to avoid misinterpretation of the inflammatory response and fluid accumulation as an infection. Localization and extension of graft infections were visualized in the images. Results: Fluorodeoxyglucose (FDG) uptake by the vascular prosthesis was accepted as infection, and these grafts were removed. Grafts with no FDG uptake compatible with infection were considered as inflammation, and medical treatment was applied. All patients were discharged without complication. Conclusion: PET scan facilitates the diagnosis of infection in suspected grafts and prevents unnecessary surgical intervention. It is also accepted as a guide for diagnosis and treatment of graft infection.