• Vol. 41 No. 8, 335–338
  • 15 August 2012

Unused Arteriovenous Grafts as a Source of Chronic Infection in Haemodialysed Patients with Relevance to Diagnosis of Fluorodeoxyglucose PET/CT Examination

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ABSTRACT

Introduction: Clotted arteriovenous grafts (AVG) for haemodialysis which are not used (silent grafts) can serve as a potential source of chronic bacterial infection in patients on dialysis programs. In some cases, the local finding is unclear. The patient only suffers from repeated metastatic infection and the detection of AVG infection is difficult. Nuclear medicine methods have the potential to uncover AVG infection. In this study, we correlated the positron emission tomography (PET)/ computed tomography (CT) findings of the AVG examination with the microbiological findings from removed grafts. The aim was to evaluate the relevance of the Fluorodeoxyglucose (FDG) PET/CT method in detecting clotted graft infection.

Materials and Methods: A cohort of 13 patients with clotted grafts were followed-up. Four patients had overall symptoms of infection and 9 patients were asymptomatic. In all cases, the PET CT examination and microbiological examination of the removed graft were provided.

Results: Only one mismatch—negative PET CT finding and positive microbiological culture was recorded in the 13 followed-up patients.

Conclusion: In patients with silent grafts and recurrent infection of equivocal aetiology, PET CT examination can contribute to the diagnosis of AVG infection and, subsequently, to prevent further infectious complications, if the AVG infection is treated appropriately and the graft is removed.


As a primary dialysis access, autologous, arteriovenous fistulas (AVF) is recommended in Europe and in North America. In patients who lack a suitable autologous subcutaneous venous circulation for AVF creation, an arteriovenous graft (AVG) is inserted between arterial and venous bed and serves as a cannulation segment. There are a variety of AVG modifications in terms of localisation, width and quality of wall. The ePTFE prosthesis is considered a golden standard in term of material. Its use however is associated with complications: stenotic and thrombotic complications on the venous anastomoses and on the cannulation side are the most common. Another serious complication is AVG infection which can lead not only to graft loss but also to metastatic infectious complications and sepsis

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