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Tracheo-innominate artery fistula successfully treated by endovascular stent-graft repair

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Abstract

We report two patients who developed a tracheo-innominate artery fistula (TIF) after tracheostomy. Contrast-enhanced computed tomography revealed a pseudoaneurysm of the innominate artery protruding into the trachea. Stent grafts were deployed for the innominate artery via two different access routes: the transfemoral approach and the right carotid artery approach. Endovascular stent-graft repair resulted in complete exclusion of the TIF and control of the bleeding from the tracheal stoma. At 12- and 16-month follow-ups, neither patient had clinical signs of graft infection, recurrent fistulization, or ischemic complications. It is feasible and useful to employ the carotid artery approach for stent-graft implantation in patients who have vascular anatomical limitations for the transfemoral approach. Endovascular repair of TIF by stent grafting is a minimally invasive treatment that can be tolerated by patients in poor clinical condition, and is a feasible alternative to surgical treatment.

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Authors and Affiliations

  1. Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-8510, Japan

    Motoki Nakai, Hirotatsu Sato, Morio Sato, Akira Ikoma, Hiroki Sanda, Kohei Nakata, Hiroki Minamiguchi, Nobuyuki Kawai & Tetsuo Sonomura

  2. Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, 641-8510, Japan

    Yoshiharu Nishimura & Yoshitaka Okamura

Authors
  1. Motoki Nakai
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  2. Hirotatsu Sato
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  3. Morio Sato
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  4. Akira Ikoma
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  5. Hiroki Sanda
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  6. Kohei Nakata
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  7. Hiroki Minamiguchi
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  8. Nobuyuki Kawai
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  9. Tetsuo Sonomura
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  10. Yoshiharu Nishimura
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  11. Yoshitaka Okamura
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Correspondence to Motoki Nakai.

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Nakai, M., Sato, H., Sato, M. et al. Tracheo-innominate artery fistula successfully treated by endovascular stent-graft repair. Jpn J Radiol 31, 65–70 (2013). https://doi.org/10.1007/s11604-012-0143-y

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  • DOI: https://doi.org/10.1007/s11604-012-0143-y

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