2015 Volume 24 Issue 7 Pages 963-966
Twenty-one years old woman was diagnosed with WEST syndrome and spastic quadriplesgia at age 7 months. She underwent tracheotomy at age 15 years due to repeated respiratory infections and laryngo-tracheal separation at age 20 years due to advanced lateral curvature. Periodic bronchoscopic examination demonstrated a beating of brachiocephalic artery in her trachea, which was thought to be a risk factor of trachea-innominate artery fistula. Preoperative computed tomography demonstrated the anatomical location of brachiocephalic artery and a communication of basilar artery. In the operation, we confirmed blood pressure in right upper limb decreased only mildly and regional cerebral oxygen saturation did not change by clamping the brachiocephalic artery. After resection of the medial head left clavicula and left upper sternum, brachiocepharic artery was transected in the midpoint. There was no postoperative complication such as a cerebral vascular accident and an ischemia of right upper limb. She was discharge at postoperative day 9.
