Tortuosity of the brachiocephalic artery complicated with arterial injury after tracheotomy: a case report
1Department of Emergency and Critical Care Medicine, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
DOI: 10.22514/SV151.042019.12 Vol.15,Issue 1,April 2019 pp.77-78
Published: 23 April 2019
Tracheotomy is an operation of the airway performed even on critical care patients. Surgical complications of tracheotomies are fatal. In this study, tortuosity of the brachiocephalic artery complicated with arterial injury was observed in a patient af-ter tracheotomy. A 95-year-old woman in coma was admitted to our medical center. The patient needed airway management, and tracheal intubation was performed. The cause of the coma was extensive cer-ebral infarction of the right middle cer-ebral artery. It was expected that the coma would be prolonged, and a tracheotomy was performed after 7 days. Tortuosity of the brachiocephalic artery was confirmed with cervical computed tomography be-fore surgery. The patient bled through the tracheostomy after 30 days. To arrest bleeding from the right common carotid artery, a vascular repair surgery was per-formed. There was no recurrent bleeding after surgery. After 37 days, the patient died of deteriorating primary disease. Although tracheotomy is a common operation, at-tention should be paid to abnormalities of blood vessels including tortuosity of the brachiocephalic artery.
arterial injury, brachiocephalic artery, complications, critical care, trache-otomy
KAZUNARI AZUMA,SHOUJI SUZUKI,YURI ISHII,YASUHIRO UEDA,TSUBASA FUJIKAWA,KENTARO MORINAGA,KEIICHIRO SHIMOYAMA,JUN ODA. Tortuosity of the brachiocephalic artery complicated with arterial injury after tracheotomy: a case report. Signa Vitae. 2019. 15(1);77-78.
1. Hori Y, Hashimoto S, Katori Y, Koiwa T, Hozawa K, Kobayashi T. Tracheostomy in tortuous brachiocephalic artery. Nihon Jibiinkoka Gakkai kaiho 2004;107:152-5.
2. Horiguchi M, Izumiyama M, Yan J, Isogai S, Aizawa Y, Ohno T. Tortuous courses of the brachiocephalic and/or common carotid arteries anterior to the superior part of the trachea should be noted in tracheotomy. Japanese Research Society of Clinical Anatomy 2002;2:14-5.
3. Uematsu M, Okada M. Tortuous carotid arteries presenting as a cervical pulsatile mass. Jpn j Vasc Surg 1999;8:465-71.
4. Shlugman D, Satya-Krishna R, Loh L. Acute fatal haemorrhage during percutaneous dilatational tracheostomy. BJA 2003;90:517-20.
5. Kimijima T, Masuda Y, Tatsumi H, Goto K, Nawa Y, Yama N, et al. A percutaneous dilatational tracheotomy in a patient with bra-chiocephalic artery tortuous. J Jpn Soc Intensive Care Med 2016;23:179-80.
6. Chew JY, Cantrell RW. Tracheostomy. Complications and their management. Arch Otolaryngol (Chicago, Ill : 1960) 1972;96:538-45.
7. Jones JW, Reynolds M, Hewitt RL, Drapanas T. Tracheo-innominate artery erosion: Successful surgical management of a devastating complication. Ann Surg 1976;184:194-204.
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