Positive imaging of an inflammatory process at an arteriovenous access site with 111 Indium-labeled platelets.

Complications associated with the vascular access for hemodialysis represent one of the most important causes of morbidity among patients with renal replacement therapy. Early detection of arteriovenous fistula (AVF) dysfunction is of great interest. We present the case of a 70 year old woman who underwent 111In-oxine-labeled-platelet scintigraphy to evaluate thrombogenicity at 3 weeks and 3 months after surgery of a new AVF. In the first post-operative scintigraphy 4 hours after reinjection of autologous 111In-labeled platelets, enhanced focal activity was visible in the AVF projection which could not be detected after 24 hours. Since early platelet accumulation may reflect hyperemia in inflammation, this diagnosis was verified by anti-granulocyte antibody scintigraphy. The platelet scintigraphy performed 3 months later was negative, with persistence of sufficient AVF function. These data show an intense early accumulation of 111In-oxine-labeled-platelets in unspecific inflammation of an AVF.