INTRAVASCULAR ULTRASOUND DIAGNOSIS OF AORTIC GRAFT INFECTION

Background. To assess the value of intra-aortic ultrasound (US) for di agnosing intraprosthetic vegetations in atypical aortic graft infectio n. Methods, A 66-year-old man presented with fever 12 months after eme rgency insertion of a straight infrarenal aortic graft because of rupt ure of an inflammatory abdominal aneurysm. Blood cultures, leukocyte s can, transabdominal US study, and digital angiography were negative. S piral CT was equivocal. The patient was imaged with a mechanically rot ating US transducer at 12.5-MHz from inside the graft. Results. Intrav ascular 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 bo th feet. At operation the presence of graft infection was confirmed. C onclusions. This case report suggests that intra-aortic US may constit ute a helpful adjunctive modality in suspected atypical infection of p rosthetic aortic grafts.