Tracheoinnominate fistula in a Duchenne muscular dystrophy patient: successful management with an endovascular stent.
Tracheoinnominate fistula is a rare but often fatal complication occurring in Duchenne Muscular Dystrophy (DMD) patients with long-term tracheostomy. We report a 16-year-old boy with DMD who developed a fistula causing massive haemorrhage 26 months after tracheostomy. Due to the high risk of perioperative complications, a minimally invasive technique with placement of an endovascular stent grafting the innominate artery was performed. The patient was successfully managed and recovered uneventfully. We believe that endovascular repair of tracheoinnominate fistula by stent grafting may be the treatment of choice in severely compromised patients and that clinicians who treat tracheostomised DMD patients should be familiar with this management strategy.
Vianello
Andrea
A
U.O. Fisiopatologia Respiratoria, Azienda Ospedaliera di Padova, Via Giustiniani, 3, 35128 Padova, Italy. avianello@qubisoft.it
Ragazzi
Roberto
R
Mirri
Loris
L
Arcaro
Giovanna
G
Cutrone
Cesare
C
Fittà
Claudio
C
D000293:Adolescent; D000792:Angiography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D016122:Brachiocephalic Trunk / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000150:complications / Q000000981:diagnostic imaging*; D015607:Stents; D014132:Trachea; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*