Abstract
BackgroundTracheostomy is a standard procedure in critically ill patients requiring mechanical ventilation or airway protection for extended periods. The main cause of death is haemorrhage, most commonly owing to a trachea-to-innominate artery fistula, usually requiring surgical treatment.Case presentationHere we report the case of an 83-yr-old woman with a subarachnoid haemorrhage, who incurred a trachea-to-innominate artery transfixion following percutaneous tracheostomy, successfully and conservatively managed by interventional radiology.ConclusionsThe use of peri-procedural ultrasound examination of the neck can reduce the risk of complications related to vessel anatomical variants. When the tracheostomy is complicated by bleeding, the procedure should be stopped in order to diagnose the vascular iatrogenic injury and to evaluate the best therapeutic approach by a multidisciplinary team.
Highlights
Tracheostomy is a standard procedure in critically ill patients requiring mechanical ventilation or airway protection for extended periods
Case presentation Here we report a case of intra-operative direct injury of the innominate artery caused by percutaneous dilatational tracheostomy, conservatively managed by interventional radiology
The patient was an 83-yr-old woman with a subarachnoid haemorrhage due to the rupture of a right carotid-ophthalmic aneurysm, treated 10 years before by endovascular embolization with coils
Summary
The use of peri-procedural ultrasound examination of the neck can reduce the risk of complications related to vessel anatomical variants.
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