The tracheoinnominate fistula (TIF) is a potentially lethal complication traditionally associated with open tracheostomy. Currently, standard treatment involves surgical diversion or occlusion of the innominate artery. Herein, we report the case of a 10-year-old girl with a TIF treated acutely with endovascular stenting; no surgical therapy was undertaken. The patient has been doing well since the procedure, with no associated complications and no further hemorrhaging. Based on the high mortality rate associated with surgical intervention, we believe that endovascular stenting should be considered as the first-line treatment for TIF in the acute setting.
Joshi AS, Tanna N, Elmaraghy CA, Obokhare I, Ponsky TA, Pena MT, Slack MC. Nonsurgical Treatment of Tracheoinnominate Fistula in the Pediatric Population. Arch Otolaryngol Head Neck Surg. 2007;133(3):294-296. doi:10.1001/archotol.133.3.294