Related Experiment Video
Updated: May 23, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Preemptive Surgical Strategies for Impending Tracheo-Innominate Artery Fistula: A Case Series of Three High-Risk
Yotaro Mori1, Tomoki Nishimura1, Noriyuki Takashima1
1Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
Abstract:
Tracheo-innominate artery fistula (TIF) is a rare but catastrophic complication of tracheostomy with extremely high mortality after rupture. No established guidelines exist for preemptive intervention in impending TIF. We report 3 high-risk patients with objective imaging and/or bronchoscopic warning signs who underwent individualized preemptive surgical management. Risk assessment included computed tomography or magnetic resonance imaging, bronchoscopy, and intraoperative cerebral perfusion monitoring during temporary innominate artery clamping. Strategies included muscle interposition, ligation, or intrathoracic bypass reconstruction. All patients recovered without neurological complications, and no TIF occurred during follow-up. Preemptive intervention may be considered only in carefully selected patients with objective warning signs.
Related Concept Videos
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Tracheostomy Care I: Pre-procedural Steps
Required Equipment
The equipment necessary for tracheostomy care includes:
Aneurysm III: Interprofessional Care
Trachea
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of the...
Tracheostomy: Procedure and Tubes
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Aneurysm IV: Nursing Management