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Angiología
versión On-line ISSN 1695-2987versión impresa ISSN 0003-3170
Resumen
FERNANDEZ LORENZO, Javier; LOPEZ ARQUILLO, Irene María; VIDAL REY, Jorge y ENCISA DE SA, José Manuel. Endovascular treatment of tracheo-innominate fistula. Angiología [online]. 2021, vol.73, n.3, pp.151-154. Epub 14-Jun-2021. ISSN 1695-2987. https://dx.doi.org/10.20960/angiologia.00223.
Introduction:
tracheo-innominate fistula (TIF) is a rare complication (0.1-1 %) of tracheotomies and endotracheal intubations. It has a high associated morbidity and mortality (90 %), and thus needs early diagnosis and treatment.
Case report:
we present the case of a 53-year-old man who underwent total laryngectomy with bilateral cervical lymphadenectomy, and who on the second postoperative day presented active bleeding from the tracheostomy tube. The patient underwent an urgent CT angiography that revealed a fistula between the brachiocephalic trunk (BCT) and the trachea in a position with the tracheostomy tube over the BCT. Expandable balloon covered stent (BeGraft®, Bentley InnoMed, Hechingen, Germany) is deployed from the origin of the BCT to its bifurcation through right humeral approach. The patient is discharged one month after endovascular surgery, presenting a satisfactory postoperative period with the absence of complications.
Discussion:
TIF is a rare and highly lethal complication that requires emergency management. Typically, TIF were first repaired by open surgery with a survival rate of 25-50 %.
Treating TIF in selected cases with the use of endovascular techniques appears to be a safe and effective choice with lower associated morbidity and mortality.
Palabras clave : Tracheo-innominate fistula; Endograft; Tracheostomy; Innominate artery.