Innominate artery hemorrhage following tracheostomy

Area of Science:

• Vascular Surgery
• Critical Care Medicine
• Otolaryngology

Background:

• Innominate artery hemorrhage is a rare but life-threatening complication following tracheostomy.
• Understanding predisposing factors and effective management strategies is crucial for patient outcomes.

Observation:

• A case of massive innominate artery hemorrhage 11 days post-tracheostomy in an 80-year-old patient is presented.
• Literature review highlights clinical presentation, prevention, and management options.

Findings:

• Emergency median sternotomy with ligation and resection of the affected innominate artery segment was successfully performed.
• This approach resulted in no neurological or vascular sequelae for the patient.

Implications:

• Simple preventive measures can minimize the risk of innominate artery hemorrhage.
• Ligation and resection without reconstruction demonstrate superior outcomes and lower complication rates than vascular reconstruction or bypass.
• Resection without reconstruction is a safe and effective management strategy for innominate artery hemorrhage post-tracheostomy.