title: Protection of high-riding aberrant innominate artery during open tracheotomy.
abstract: OBJECTIVE
  Variations of the normal anatomy of the aortic great vessels can lead to severe complications if not recognised pre- or peri-operatively. One such anomaly is a high-riding aberrant innominate artery.
  
  
  METHODS
  Retrospective review of case series.
  
  
  METHODS
  We present our experience with seven patients in whom a high aberrant innominate artery was encountered just before or during open tracheotomy. We describe a procedure designed to protect the artery from erosion due to the tracheotomy tube, using an inferiorly based, U-shaped flap from the anterior tracheal wall averted over the innominate artery.
  
  
  RESULTS
  None of the patients had any bleeding from the tracheotomy site, during a follow-up period of nine to 46 months.
  
  
  CONCLUSIONS
  The technique described is simple to perform and prevents any damage to a high aberrant innominate artery, as assessed over a long follow-up period.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rambam Health Care Campus, The Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Netzer
authors.forename: D
authors.initials: D
authors.lastname: Ostrovsky
authors.forename: R
authors.initials: R
authors.lastname: Bar
authors.forename: S T
authors.initials: ST
authors.lastname: Westerman
authors.forename: A
authors.initials: A
authors.lastname: Golz
mesh_terms: D016122:Brachiocephalic Trunk / Q000002:abnormalities* / Q000000981:diagnostic imaging; D057785:Catheters / Q000009:adverse effects; D006801:Humans; D033162:Incidental Findings; D019990:Perioperative Care / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D016156:Respiratory Tract Fistula / Q000517:prevention & control; D012189:Retrospective Studies; D013524:Surgical Flaps; D014140:Tracheotomy / Q000009:adverse effects / Q000379:methods*; D014463:Ultrasonography