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

Motoki Nakai, Hirotatsu Sato, Morio Sato, Akira Ikoma, Hiroki Sanda, Kohei Nakata, Hiroki Minamiguchi, Nobuyuki Kawai, Tetsuo Sonomura, Yoshiharu Nishimura, Yoshitaka Okamura

Japanese journal of radiology 2013 Jan

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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.

Citation

Motoki Nakai, Hirotatsu Sato, Morio Sato, Akira Ikoma, Hiroki Sanda, Kohei Nakata, Hiroki Minamiguchi, Nobuyuki Kawai, Tetsuo Sonomura, Yoshiharu Nishimura, Yoshitaka Okamura. Tracheo-innominate artery fistula successfully treated by endovascular stent-graft repair. Japanese journal of radiology. 2013 Jan;31(1):65-70