Tortuosity of the brachiocephalic artery complicated with arterial injury after tracheotomy: a case report

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

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