PET/CT in therapy control of infective native aortic aneurysms

Husmann, Lars; Huellner, Martin W.; Eberhard, Nadia; Ledergerber, Bruno; Kaelin, Marisa; Anagnostopoulos, Alexia; Kudura, Ken; Burger, Irene A.; Mestres, Carlos–A.; Rančić, Zoran; Hasse, Barbara

doi:10.1038/s41598-021-84658-z

Cited by 12 publications

(10 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Along with previous results, the time-to-infection did not influence basic uptake values; however, the type of initial operation (EVAR vs. OAR) might ( Table 2 ) [ 7 , 22 ]. Similar results have been reported from smaller cohort studies and meta-analyses and also after open ascending aortic repair [ 23 , 24 , 25 , 26 , 27 , 28 ]. Yet, quantitative PET analysis could be suggestive of perigraft gas bubbles, but no correlations with eventual bacteria and clinical outcomes of VGEI are reported [ 6 , 29 ].…”

Section: Discussionsupporting

confidence: 89%

Aortic Vascular Graft and Endograft Infection–Patient Outcome Cannot Be Determined Based on Pre-Operative Characteristics

Puttini,

Kapalla,

Braune

et al. 2024

JCM

View full text Add to dashboard Cite

Vascular graft/endograft infection (VGEI) is a serious complication after aortic surgery. This study investigates VGEI and patient characteristics, PET/CT quantification before surgical or conservative management of VGEI and post-intervention outcomes in order to identify patients who might benefit from such a procedure. PET standard uptake values (SUV) were quantitatively assessed and compared to a non-VGEI cohort. The primary endpoints were in-hospital mortality and aortic reintervention-free survival at six months. Ninety-three patients (75% male, 65 ± 10 years, 82% operated) were included. The initial operation was mainly for aneurysm (67.7%: 31% EVAR, 12% TEVAR, 57% open aortic repair). Thirty-two patients presented with fistulae. PET SUVTLR (target-to-liver ratio) showed 94% sensitivity and 89% specificity. Replacement included silver-coated Dacron (21.3%), pericardium (61.3%) and femoral vein (17.3%), yet the material did not influence the overall survival (p = 0.745). In-hospital mortality did not differ between operative and conservative treatment (19.7% vs. 17.6%, p = 0.84). At six months, 50% of the operated cohort survived without aortic reintervention. Short- and midterm morbidity and mortality remained high after aortic graft removal. Neither preoperative characteristics nor the material used for reconstruction influenced the overall survival, and, with limitations, both the in-hospital and midterm survival were similar between the surgically and conservatively managed patients.

show abstract

Section: Discussionsupporting

confidence: 89%

Aortic Vascular Graft and Endograft Infection–Patient Outcome Cannot Be Determined Based on Pre-Operative Characteristics

Puttini,

Kapalla,

Braune

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

“…In our study, multiple [ 18 F]FDG-PET/CT scans were made in many patients, and discontinuation of antibiotic treatment was not always based on [ 18 F]FDG-PET/CT results only. A recent study in 15 patients treated with open or endovascular repair because of infected native aortic aneurysms showed that [ 18 F]FDG-PET/CT showed large discrepancies between trends of CRP and metabolic activity or even opposed course [ 20 ]. Metabolic activity in the aneurysms remained slightly elevated after the end of antibiotic treatment in patients without any signs of infection at follow-up.…”

Section: Discussionmentioning

confidence: 99%

Thoracic aortic vascular graft infection: outcome after conservative treatment without graft removal

Kouijzer

Baranelli

Maat

et al. 2022

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

Objectives Surgical debridement with aortic graft removal is considered the preferred treatment for thoracic aortic vascular graft infection (VGI). Conservative treatment with antibiotics only is usually reserved for inoperable patients. Due to Outpatient Parenteral Antimicrobial Therapy (OPAT) and better understanding of the antibiotic impact on biofilms, long-term targeted antibiotic therapy without graft removal may be an alternative treatment option for selected thoracic aortic VGI patients. The aim of this case series was to evaluate the outcome in patients with thoracic aortic VGI who were treated without graft removal. Methods This single-centre retrospective cohort study evaluated patients with a thoracic aortic VGI diagnosed between 2008 and 2021 and who were treated without graft removal. Primary outcome parameter was 6-month mortality rate after VGI diagnosis. Secondary outcome parameters were cure rates and relapse of infection. Results Twenty-four patients with thoracic aortic VGI who were managed without graft removal were identified. Mortality rate six months after VGI diagnosis was 8% (2/24), one of these deaths was infection-related. Median antibiotic treatment duration was 13 months (IQR 15). A total of 16 patients (67%) were cured. No relapses occurred after a median of 24 months (IQR 32) follow-up. Conclusions Intensive antibiotic treatment, without graft removal, may be a non-inferior option in patients with a thoracic aortic VGI who are not considered for surgery.

show abstract

“…Instead, we enrolled as many cases as possible, referencing the prior literature. [18][19][20] The study protocol was developed and approved by the Ethics Committee of Nagoya City University Hospital (control number: 60-22-0112) before data collection and analysis. This study was also registered at umin.ac.jp (UMIN R000056536).…”

Section: Methodsmentioning

confidence: 99%

A novel use of diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression to diagnose infectious aortitis

Saito,

Muto,

Tada

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Diffusion-weighted whole-body imaging with background body signal suppression is one of the whole-body magnetic resonance imaging techniques and is effective in diagnosing inflammatory and infectious diseases. We aimed to evaluate the diagnostic performance of this modality in infectious aortitis, which remains unclear. Methods: The study participants were 32 patients with suspected infectious aortitis who underwent computed tomography and magnetic resonance imaging between September 2020 and November 2022. Sensitivity, specificity, and areas under the curve of each imaging modality were studied using a diagnosis based on a combination of imaging results, clinical symptoms, and laboratory tests. Decision curve analysis was performed to determine the benefit of adding magnetic resonance imaging to computed tomography. Results: The median age was 74 years, and 23 participants were men. Fifteen patients (47%) were diagnosed with infectious aortitis. Positive findings for infectious aortitis were identified in 19, 18, and 14 patients by computed tomography, diffusion-weighted whole-body imaging, and the combination of both modalities, respectively. Sensitivity, specificity, and area under the curve for correct diagnosis were 93.3%, 70.6%, and 0.82 (95% confidence interval 0.69?0.95), respectively for computed tomography, 93.3%, 76.5%, and 0.85% (95% confidence interval 0.73%?0.97), respectively for diffusion-weighted imaging, and 86.7%, 94.1%, and 0.90 (95% confidence interval 0.80?0.10), respectively for the combination of both modalities. Decision curve analysis reinforced the clinical benefit of combining the two imaging modalities across all ranges of the probability thresholds. Conclusions: Diffusion-weighted whole-body imaging with background body signal suppression is an effective diagnostic tool for infectious aortitis, especially when combined with computed tomography.

show abstract

PET/CT in therapy control of infective native aortic aneurysms

Cited by 12 publications

References 24 publications

Aortic Vascular Graft and Endograft Infection–Patient Outcome Cannot Be Determined Based on Pre-Operative Characteristics

Aortic Vascular Graft and Endograft Infection–Patient Outcome Cannot Be Determined Based on Pre-Operative Characteristics

Thoracic aortic vascular graft infection: outcome after conservative treatment without graft removal

A novel use of diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression to diagnose infectious aortitis

Contact Info

Product

Resources

About