Tracheo‐innominate artery fistula: Diagnosis and surgical management

Wang, Xiaolei; Xu, Zhengang; Tang, Ping-zhang; Yu, Yue

doi:10.1002/hed.23211

Cited by 27 publications

(37 citation statements)

References 16 publications

(22 reference statements)

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“…This is due to the mechanical force generated by the cuff or tip of the tracheostomy tube. The necrosis of the trachea can occur by a low-lying tracheostomy tube below the 3rd to 4rd trachea rings, overinflated cuffs, high-riding innominate artery, local infections by the tracheal defects, prolonged tracheostomy, or neck and chest deformities41112). In our case, the tracheostomy site was located below the 4th tracheal ring, and the innominate artery was located at midtrachea.…”

Section: Discussionmentioning

confidence: 66%

Endovascular stenting of tracheoinnominate fistula after tracheostomy in a 14-year-old boy

et al. 2016

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Tracheoinnominate artery fistula is a rare, fatal complication of tracheostomy, and prompt diagnosis and management are imperative. We report the case of tracheoinnominate artery fistula after tracheostomy in a 14-year-old boy with a history of severe periventricular leukomalacia, hydrocephalus, cerebral palsy, and epilepsy. The tracheoinnominate artery fistula was successfully treated with a stent graft insertion via the right common femoral artery. Endovascular repair of the tracheoinnominate artery fistula via stent grafting is a safe, effective, and minimally invasive treatment for patients in poor clinical conditions and is an alternative to traditional open surgical treatment.

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Section: Discussionmentioning

confidence: 66%

Endovascular stenting of tracheoinnominate fistula after tracheostomy in a 14-year-old boy

et al. 2016

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“…The mortality rate approaches 100% without urgent surgery as opposed to 20% with early recognition and proper management. 14,15 If TIF is a possibility, bronchoscopy should be considered carefully as it can destabilize a clot that is preventing massive hemorrhage. Although bronchoscopy is unlikely to identify the fistula opening per se, it may exclude other pathology such as irritation, infection, erosion, or ulceration of tracheal mucosa.…”

Section: Discussionmentioning

confidence: 99%

Tracheoinnominate Artery Fistula Formation in a Child with Long-Term Tracheostomy Dependence

Chauhan

Hertzog

Viteri

et al. 2018

J Pediatr Intensive Care

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We report a fatal tracheoinnominate artery fistula (TIF) in a 13-year-old female patient with long-term tracheostomy tube dependence due to chronic respiratory failure. Thirteen years after placement of her tracheostomy tube, the patient experienced two separate episodes of sentinel bleeding prior to a fatal hemorrhagic event. Diagnostic evaluation after the sentinel events was mostly nonconclusive. This case highlights the risk of TIF in pediatric age group, even years after initial tracheostomy tube placement, and the need for a high index of suspicion for TIF when children present with unexplained tracheal bleeding.

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“…9 The best therapeutic strategy is not to place the tracheostomy tube distal of the fourth tracheal ring; avoid hyperextension of the neck; and maintain cuff pressure below 20 mmHg, to prevent necrosis of the mucosa. 10 Generally, traumatic arterial lesions are treated using traditional revascularization techniques. However, it is becoming increasingly possible to repair, in an effective way, vascular injuries with minimally invasive procedures.…”

Section: Discussionmentioning

confidence: 99%

Tratamento endovascular de fístula tronco arterial braquiocefálico-traqueal: relato de caso e revisão de literatura

Machado¹,

Barroso²

2018

J. vasc. bras.

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Tracheo-innominate artery fistula (TIF) is a rare complication of tracheostomy, with incidence ranging from 0.1 to 1%, but mortality is high in untreated cases. Early signs range from self-limited bleeding to massive hemorrhage with hypovolemic shock. The caliber of the tracheostomy cannula, its position in contact with the tracheal wall, and tracheal cuff pressure can traumatize the mucosa and trigger development of a TIF. We describe the case of a 14-year-old female patient who had been tracheostomized at the age of eight because of head trauma. She later developed subglottic stenosis requiring dilation sessions for six years. During the fifth year of these sessions, she presented repetitive hemoptysis, initially treated by surgery to implant an expanded polytetrafluoroethylene graft. One year later, she had an intense hemorrhage, which was controlled using endovascular techniques followed by definitive surgery, performed electively. The patient was followed up for six months, without complications.

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Tracheo‐innominate artery fistula: Diagnosis and surgical management

Abstract: Prompt diagnosis and surgical intervention can save the life of a patient with TIF. Prevention is vital because of the high mortality of this disease.

Cited by 27 publications

References 16 publications

Endovascular stenting of tracheoinnominate fistula after tracheostomy in a 14-year-old boy

Endovascular stenting of tracheoinnominate fistula after tracheostomy in a 14-year-old boy

Tracheoinnominate Artery Fistula Formation in a Child with Long-Term Tracheostomy Dependence

Tratamento endovascular de fístula tronco arterial braquiocefálico-traqueal: relato de caso e revisão de literatura

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