A Case of Successful Surgical Management of Tracheo-Innominate Artery Fistula after Endovascular Repair
- VernacularTitle:気管腕頭動脈瘻による気道出血に対して小口径ステントグラフトを留置した3カ月後，再出血を来たし腕頭動脈離断術を行った1例
- Author:
Shuhei SUZUKI
1
;
Hiroyuki HIRAHARA
1
;
Masaaki SUGAWARA
1
Author Information
- Keywords: tracheo-innominate artery fistula; after endovascular repair; transection of brachiocephalic artery
- From:Japanese Journal of Cardiovascular Surgery 2023;52(3):189-192
- CountryJapan
- Language:Japanese
- Abstract: A 15-year-old girl who had undergone a tracheostomy 4 years earlier because of holoprosencephaly and severe mental and physical disabilities had tracheo-innominate artery fistula with sudden-onset bleeding after endotracheal suctioning. Due to respiratory and circulatory instability, VIABAHN® was implanted in the brachiocephalic artery, and the patient was discharged on postoperative day 33. Three months later, rebleeding from the tracheostomy site was observed, and the patient was transported to our hospital. Although the bleeding stopped spontaneously on arrival, the patient experienced multiple bleeding episodes after admission. Therefore, transection of brachiocephalic artery was performed, after which the patient was discharged on postoperative day 20. Tracheo-innominate artery fistula is a rare complication that occurs after tracheostomy, but it is associated with a poor prognosis, and has a mortality rate of 100% if left untreated. Our case suggests that endovascular treatment using VIABAHN® for tracheo-innominate artery fistula is useful for temporary hemostasis.
