Endovascular Treatment of Tracheoinnominate Artery Fistula: Case Report and Literature Review With Pooled Cohort Analysis

Taechariyakul, Thotsophon; Keller, Frederick S.; Jahangiri, Younes

doi:10.1053/j.semtcvs.2019.08.006

Cited by 14 publications

(29 citation statements)

References 23 publications

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“…TIF is a devastating complication of prolonged tracheostomy. The incidence has been reported at 0.1%-1% in different case series, and this may represent an underestimation due to underreporting and high early mortality rates [7,8]. New bleeding around an established tracheostomy site should prompt immediate evaluation for TIF.…”

Section: Discussionmentioning

confidence: 99%

“…New bleeding around an established tracheostomy site should prompt immediate evaluation for TIF. Approximately 35%-50% of patients develop a sentinel or intermittent bleed prior to life-threatening hemorrhage [6,7]. The leading cause for the development of TIF is thought to be pressure necrosis of the anterior tracheal wall caused by the tracheostomy tube and erosion into the innominate artery [6,8,11].…”

Section: Discussionmentioning

confidence: 99%

“…The leading cause for the development of TIF is thought to be pressure necrosis of the anterior tracheal wall caused by the tracheostomy tube and erosion into the innominate artery [6,8,11]. Factors that can increase the risk of fistula formation include positioning of tracheostomy below the fourth trachea ring, prolonged or repeated overinflation of the tracheostomy balloon, a high riding innominate artery, local infection, and previous radiation or operation [6,7].…”

Section: Discussionmentioning

confidence: 99%

“…Risks of endovascular management include stent infection, occlusion, and erosion into the trachea with rebleeding [4,9]. Most of the patients who developed these complications had evidence of previous sternotomy, chest wall deformity, or multiple comorbidities, also making them highrisk candidates for the surgical treatment [4][5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…This high mortality is attributed to the difficulty of controlling the hemorrhage preoperatively, high infection rates postoperatively, and the patients often present with other comorbid conditions. Given the high mortality and morbidity rates with a standard operative approach, endovascular stenting has been described as an alternative intervention [4][5][6][7][8][9]. We present a case of a patient with TIF who was successfully treated with endovascular stenting of the innominate artery.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Tracheoinnominate Artery Fistula Treated With Endovascular Stent Graft at a Level I Trauma Center

Laswi

Vega

Jones

et al. 2020

Cureus

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Tracheoinnominate artery fistula could be a fatal complication of tracheostomy. Herein, we present the case of a 59-year-old male with sentinel bleeding around the tracheostomy with subsequent workup revealing a tracheoinnominate fistula. Subsequently, the patient was managed with an endovascular approach with a subsequent favorable outcome. We reported an alternative approach to the management of this catastrophic complication in patients who are at high risk for complications from conventional treatment approach.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Tracheoinnominate Artery Fistula Treated With Endovascular Stent Graft at a Level I Trauma Center

Laswi

Vega

Jones

et al. 2020

Cureus

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Tracheo-Innominate Fistula—Stent or Sternotomy?

Inkollu

2020

Seminars in Thoracic and Cardiovascular Surgery

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Successful management of a tracheomalacia patient with active endotracheal bleeding due to intraoperative innominate artery injury: A case report

Park

Kim²,

Jung³

2022

Medicine

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Rationale: Intraoperative innominate artery injury is life-threatening in tracheomalacia patients with prolonged tracheostomy. Anesthetic management is challenging in cases with massive hemorrhage into the endotracheal tube. We report a case in which we successfully managed a tracheomalacia patient with acute endotracheal bleeding due to innominate artery injury. Patient concerns: A 24-year-old patient with tracheomalacia was scheduled to undergo exploratory thoracotomy for the treatment of intermittent bleeding at the tracheostomy site. During exploration, sudden active bleeding due to innominate artery injury was observed in the endotracheal lumen. Diagnoses: The patient was diagnosed with tracheomalacia. Interventions: We immediately used the bronchoscope to place the tip of the endotracheal tube at the bleeding site and hyperinflated the cuff. Outcomes: The ballooned cuff compressed the active bleeding site, so no additional bleeding was detected by bronchoscopy, and no additional massive bleeding was observed in the operative field. Lessons: Immediate and appropriate overinflation of the endotracheal tube cuff by an anesthesiologist may provide improved surgical field visibility and time for critical surgical procedures in cases of massive hemorrhaging.

show abstract

Endovascular Treatment of Tracheoinnominate Artery Fistula: Case Report and Literature Review With Pooled Cohort Analysis

Cited by 14 publications

References 23 publications

Tracheoinnominate Artery Fistula Treated With Endovascular Stent Graft at a Level I Trauma Center

Tracheoinnominate Artery Fistula Treated With Endovascular Stent Graft at a Level I Trauma Center

Tracheo-Innominate Fistula—Stent or Sternotomy?

Successful management of a tracheomalacia patient with active endotracheal bleeding due to intraoperative innominate artery injury: A case report

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