2017 Volume 38 Issue 1 Pages 14-20
Tracheoinnominate artery fistula (TIF) is a rare but lethal complication occurring after tracheostomy or laryngotracheal separation. Although successful surgical intervention for TIF has been reported, fatal mediastinitis and severe wound infection are common post-surgical complications. Therefore, endovascular repair of TIF has been proposed as an alternative, minimally invasive procedure. We report here a 14-year-old boy with a history of meningitis-associated encephalopathy who presented with TIF 5 months after undergoing laryngotracheal separation. Following temporary control of bleeding, embolization of the innominate artery was performed with a five-piece coil. Although embolization was successful, 2 years after treatment, a piece of the coil was found to have entered the right bronchus. It was possible to remove the piece of coil using a bronchofiberscope and pliers and the subsequent postoperative follow-up was uneventful with no evidence of further bleeding. Thus, innominate artery embolization offers a valid and less invasive treatment option for TIF than open surgery. Despite this, surgeons must still be aware of its potential complications.
