Tracheoinnominate Fistula: Endovascular Treatment with a Stent Graft in a 4-Year-Old Child

Cavalcante, Rafael; Motta-Leal-Filho, Joaquim Maurício da; Maciel, Macello José Sampaio; Carnevale, Francisco César

doi:10.1016/j.avsg.2015.08.004

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…The mechanism of injury is likely to be pressure necrosis of the anterior tracheal wall leading to erosion of the posterior aspect of the innominate artery caused by the tracheostomy cuff10). This is due to the mechanical force generated by the cuff or tip of the tracheostomy tube.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, endovascular procedures involving stent graft implantation or endovascular embolization have significantly improved, and can be safely performed as an alternative to the traditional open surgical method in selected circumstances15). Cavalcante et al10) described in 2015 the case of TIF successfully treated with a stent graft in a 4-year-old boy but first endovascular procedure (coil embolization) was not successful. Although endovascular stenting does not guarantee the complete elimination of TIF and it has some complications of graft infection, graft occlusion, and rebleeding due to tracheal erosion, it may be less invasive and more expeditious than surgical exploration7).…”

Section: Discussionmentioning

confidence: 99%

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Endovascular stenting of tracheoinnominate fistula after tracheostomy in a 14-year-old boy

et al. 2016

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Tracheoinnominate artery fistula is a rare, fatal complication of tracheostomy, and prompt diagnosis and management are imperative. We report the case of tracheoinnominate artery fistula after tracheostomy in a 14-year-old boy with a history of severe periventricular leukomalacia, hydrocephalus, cerebral palsy, and epilepsy. The tracheoinnominate artery fistula was successfully treated with a stent graft insertion via the right common femoral artery. Endovascular repair of the tracheoinnominate artery fistula via stent grafting is a safe, effective, and minimally invasive treatment for patients in poor clinical conditions and is an alternative to traditional open surgical treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endovascular stenting of tracheoinnominate fistula after tracheostomy in a 14-year-old boy

et al. 2016

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“…The observed unweighted kappa for full‐text reviewing between the two independent reviewers was 0.802 (95% confidence interval (CI) 0.752–0.852). Fifty‐four publications were included in final synthesis, including 40 case reports and 14 case series, which were published between 1948 and 2017 . Studies from the United States were the most common (33.3%), followed by those from Japan (27.8%) (Supporting Appendix 2).…”

Section: Resultsmentioning

confidence: 99%

“…Eight of 54 studies reported the type of tracheotomy tubes used prior to TIF development (6 with metal tubes, and 2 with Montgomery T‐tubes, Boston Medical Products, Shrewsbury, MA). Five studies reported changing tracheotomy tubes to either metal, Bivona, or Montgomery T‐tube, Boston medical products during initial or definitive management of TIF, although the initial type of tubes at the time of presentation is not available.…”

Section: Resultsmentioning

confidence: 99%

Tracheo‐innominate fistula in children: A systematic review of literature

et al. 2019

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Objective: Tracheo-innominate fistula (TIF) is a rare but fatal complication of tracheotomy. To date, there is a paucity of literature regarding pediatric TIFs. The objectives of this study were to conduct a systematic review of literature on pediatric TIF following tracheotomy and describe three demonstrative cases from our institutional experience.Methods: We conducted a systematic review using MEDLINE, Embase, Cochrane Database of Systematic Reviews, Web of Science, and CINAHL. All studies with pediatric patients (under 18 years of age) who developed TIF following tracheotomy were included.Results: Fifty-four publications met inclusion criteria, reporting on 77 cases. The most common indication for tracheotomy was prolonged intubation and the need for ventilatory support (38.6%), with neurological comorbidities being the most common indication (72.7%). The mean time to TIF was 395.7 days (95% confidence interval, 225.9-565.5). Fifty-four patients (70.1%) presented with massive hemorrhage, whereas 18 patients (23.3%) presented with a sentinel bleeding event. The most common diagnostic interventions were computed tomography scan with or without contrast and bronchoscopy (55.8%). A substantial number of patients did not have any investigations (41.6%). Surgical management occurred in 70.1% of patients. Mortality was 38.6% in reported cases with variable follow-up periods.Conclusion: TIF may occur in long-term tracheostomy-dependent children, contrary to the conventionally described 3-week postoperative period. The mortality may not be as high as previously reported with timely intervention. Our results are limited by inherent risks of bias. Further research including well-designed cohort studies are needed to guide an evidencebased approach to TIF.

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“…5 Further reports have continued to use stent grafting as the treatment choice in children with success and known stable outcomes at several weeks to 24 months after the procedure. [6][7][8] Endovascular treatment was pursued after the patient recurred postsurgical repair as repeat surgical exploration was considered to carry unacceptable risks. The endovascular approach allows rapid control of bleeding while avoiding the morbidity of a median sternotomy, and we speculate a more favorable course had the patient been treated primarily in this manner.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Stent Graft Exclusion of an Iatrogenic Tracheoinnominate Fistula after Unsuccessful Surgical Repair

Woerner

Koo

Monroe

2018

J Clin Interv Radiol ISVIR

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A 10-year-old girl with metachromatic leukodystrophy developed a tracheoinnominate artery fistula and massive hemoptysis following tracheostomy, initially requiring open surgical repair. Massive hemoptysis recurred at 1 month due to suspected pericardial patch dehiscence. The authors herein describe the subsequent emergent treatment by stent graft exclusion and review the existing literature surrounding this rare and potentially fatal condition. AbstractKeywords ► pseudoaneurysm ► innominate artery ► stent

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Tracheoinnominate Fistula: Endovascular Treatment with a Stent Graft in a 4-Year-Old Child

Cited by 5 publications

References 10 publications

Endovascular stenting of tracheoinnominate fistula after tracheostomy in a 14-year-old boy

Endovascular stenting of tracheoinnominate fistula after tracheostomy in a 14-year-old boy

Tracheo‐innominate fistula in children: A systematic review of literature

Endovascular Stent Graft Exclusion of an Iatrogenic Tracheoinnominate Fistula after Unsuccessful Surgical Repair

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