Innominate Artery Transection via Combined Suprasternal and Intercostal Approach Prevents Tracheoinnominate Artery Fistula

Abstract

Tracheoinnominate artery fistula is a rare but potentially fatal complication of tracheostomy. We report the case of a 22-year-old male at high risk for tracheoinnominate artery fistula due to severe thoracic deformity. To mitigate the risk, a prophylactic transection of the innominate artery was successfully performed using a combined suprasternal and intercostal approach, thereby avoiding limb perfusion. The patient was discharged without complications. This case highlights the effectiveness of the combined approach for safe innominate artery transection in anatomically challenging cases.