Tracheoinnominate Artery Fistula

Tracheoinnominate artery fistula, or simply tracheoinnominate fistula, may be caused by pressure necrosis from high cuff pressure, mucosal trauma from malpositioned cannula tip, low tracheal incision, excessive neck movement, radiotherapy, and prolonged intubation.

Reports on imaging are few (at least those available electronically) and seem restricted to angiography. Normal diagnostic aortograms have been reported and should not delay treatment. Selective catheterization of the innominate artery and careful evaluation may reveal the site of the lesion.

References

Cohen JE, Klimov A, Rajz G, Paldor I, Spektor S. Exsanguinating tracheoinnominate artery fistula repaired with endovascular stent-graft. Surg Neurol. 2008 Mar;69(3):306-9.