title: Exsanguinating tracheoinnominate artery fistula repaired with endovascular stent-graft.
abstract: BACKGROUND
  Tracheoinnominate artery fistula is a relatively rare but life-threatening complication of tracheostomy. Peristomal bleed or hemoptysis may be massive and usually fatal if treatment is not instituted immediately.
  
  
  METHODS
  We report the case of a 40-year-old woman who sustained surgical evacuation of a brainstem cavernoma and developed a massive hemoptysis 13 days after a percutaneous tracheostomy. Because of the patient's poor clinical condition, endovascular repair of the arterial injury was decided. The innominate artery was successfully repaired by means of urgent stent-graft placement.
  
  
  CONCLUSIONS
  We believe that, if technically feasible, stent-graft placement can be a valuable therapeutic alternative for this dramatic condition. Physicians in charge of tracheostomized patients and neurointerventionalists should be familiar with this management strategy.
authors.affiliation: Department of Neurosurgery, Hadassah Hebrew University Hospital, 91120 Jerusalem, Israel. jcohenns@yahoo.com
authors.forename: José E
authors.initials: JE
authors.lastname: Cohen
authors.forename: Alex
authors.initials: A
authors.lastname: Klimov
authors.forename: Gustavo
authors.initials: G
authors.lastname: Rajz
authors.forename: Iddo
authors.initials: I
authors.lastname: Paldor
authors.forename: Sergei
authors.initials: S
authors.lastname: Spektor
mesh_terms: D000328:Adult; D016122:Brachiocephalic Trunk / Q000473:pathology*; D001932:Brain Neoplasms / Q000601:surgery; D001933:Brain Stem / Q000601:surgery; D005260:Female; D005402:Fistula / Q000473:pathology* / Q000601:surgery*; D020786:Hemangioma, Cavernous, Central Nervous System / Q000601:surgery; D006469:Hemoptysis / Q000209:etiology / Q000601:surgery; D006801:Humans; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000601:surgery*; D015607:Stents; D014132:Trachea; D014139:Tracheostomy / Q000009:adverse effects; D014656:Vascular Surgical Procedures / Q000379:methods*