[Is emergency revascularization of tracheo-innominate artery fistulae mandatory?].
Tracheo-innominate artery fistulas are a rare but life-threatening complications (incidence between 0.1 and 1 %) occurring in tracheostomy patients. Surgery is the treatment of choice. Most authors recommend ligation of the innominate artery, which provides better results in terms of morbidity/mortality than revascularization surgery. We report here a case of innominate artery revascularization isolated from the trachea by a sternocleidomastoid pediculate interposition graft. The procedure was successful as demonstrated by the 2 years follow-up. Revascularization surgery should be reserved of specific cases. The risk of tracheal-mediated infections developing in contact with the vascular sutures warrants systematic use of an interposition graft isolating the trachea from the innominate artery.
Bourgouin
S
S
Service de chirurgie viscérale et vasculaire, hôpital d'instruction des armées Sainte-Anne, boulevard Sainte-Anne, BP 20545, 83041 Toulon cedex 09, France. stephane bourgouin@hotmail.fr
Hornez
E
E
Monchal
T
T
Baudoin
Y
Y
Meyrat
L
L
Thouard
H
H
D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications; D016122:Brachiocephalic Trunk / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006469:Hemoptysis / Q000601:surgery; D006801:Humans; D008026:Ligation; D008480:Mediastinitis / Q000209:etiology; D009334:Neck Muscles / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D012128:Respiratory Distress Syndrome / Q000209:etiology; D016156:Respiratory Tract Fistula / Q000209:etiology / Q000601:surgery*; D012771:Shock, Hemorrhagic / Q000209:etiology; D013524:Surgical Flaps; D014133:Tracheal Diseases / Q000209:etiology / Q000601:surgery*; D014140:Tracheotomy / Q000009:adverse effects*; D016157:Vascular Fistula / Q000209:etiology / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*