The role of preoperative Tc-99m HMPAO-labeled leukocyte total-body scans in aortic prosthetic reconstruction

Purpose: This study was performed to evaluate the utility of Tc-99m HMPAO-l abeled leukocyte total-body scans (TBLS) for detecting remote septic foci b efore operation in patients undergoing aortofemoral vascular surgery. Materials and Methods: Fifty-eight patients were screened before operation for inflammatory or infective disease, and a clinical score was assigned to each patient. Each patient had TBLSs. The relation between the clinical sc ore and the TBLS result was determined. Patients with positive results of t he TBLSs were examined, and the causes of these findings were treated befor e surgery. Results: Ten of the 58 (17%) patients had a positive result of TBLSs. Of 31 patients with a clinical score of zero, 3 had positive findings of TBLS. N o TBLS was positive in the 13 patients with a clinical score of 1. TBLS fin dings were positive in 7 of 14 of the combined patients with clinical score s of 2, 3, or 4. None of the patients showed signs of prosthetic vascular g raft infection during the postoperative follow-up period. Conclusions: In conclusion, TBLSs can be used before aortofemoral vascular surgery, but only in patients with high clinical scores for inflammatory or infective disease to identify relevant infective foci that could cause vas cular graft infection.