Tracheo-innominate artery fistula successfully treated by endovascular stent-graft repair.

Abstract

We report two patients who developed a tracheo-innominate artery fistula (TIF) after tracheostomy. Contrast-enhanced computed tomography revealed a pseudoaneurysm of the innominate artery protruding into the trachea. Stent grafts were deployed for the innominate artery via two different access routes: the transfemoral approach and the right carotid artery approach. Endovascular stent-graft repair resulted in complete exclusion of the TIF and control of the bleeding from the tracheal stoma. At 12- and 16-month follow-ups, neither patient had clinical signs of graft infection, recurrent fistulization, or ischemic complications. It is feasible and useful to employ the carotid artery approach for stent-graft implantation in patients who have vascular anatomical limitations for the transfemoral approach. Endovascular repair of TIF by stent grafting is a minimally invasive treatment that can be tolerated by patients in poor clinical condition, and is a feasible alternative to surgical treatment.

• Authors: Motoki Nakai, Hirotatsu Sato, Morio Sato, Akira Ikoma, Hiroki Sanda, Kohei Nakata, Hiroki Minamiguchi, Nobuyuki Kawai, Tetsuo Sonomura, Yoshiharu Nishimura, Yoshitaka Okamura
• Journal: Japanese journal of radiology (Jpn J Radiol) Vol. 31 Issue 1 Pg. 65-70 (Jan 2013) ISSN: 1867-108X [Electronic] Japan
• PMID: 23065488 (Publication Type: Case Reports, Journal Article)

Chemical References

• Contrast Media

Topics

• Adult
• Aged
• Blood Vessel Prosthesis Implantation (methods)
• Brachiocephalic Trunk (diagnostic imaging, surgery)
• Contrast Media
• Humans
• Male
• Stents
• Tomography, X-Ray Computed
• Tracheal Diseases (diagnostic imaging, etiology, surgery)
• Tracheostomy (adverse effects)
• Vascular Fistula (diagnostic imaging, etiology, surgery)