Multimodality imaging of an aortic graft infection

Area of Science:

• Vascular Surgery
• Infectious Diseases
• Radiology

Background:

• Aortic prosthetic vascular graft infections (PVGI) are infrequent but serious complications following aortic surgery, with reported incidence rates between 0.5% and 6%.
• These infections are associated with high mortality rates, ranging from 25% to 88% in reported cases.
• Recent advancements in diagnostic imaging have improved the early detection and management of PVGI.

Observation:

• This case report highlights the utility of three key imaging modalities in diagnosing aortic PVGI.
• Transesophageal echocardiography (TEE) provides detailed views of the aorta and surrounding structures.
• Computed tomography angiography (CTA) offers comprehensive anatomical information and can detect perigraft fluid collections or gas.
• 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is valuable for identifying metabolically active infectious processes.

Findings:

• The study emphasizes the crucial role of TEE, CTA, and 18F-FDG PET/CT in the accurate assessment of aortic PVGI.
• These imaging techniques, when used judiciously, facilitate timely diagnosis.
• Improved diagnostic capabilities have contributed to a reduction in PVGI-associated mortality over the past two decades.

Implications:

• Early and accurate diagnosis of aortic PVGI through advanced imaging is critical for effective treatment and improved patient outcomes.
• The integration of TEE, CTA, and 18F-FDG PET/CT into diagnostic algorithms can significantly impact patient survival rates.
• Further research into the optimal use and combination of these imaging modalities for PVGI is warranted.