Table 1: Anatomical distribution of arterial injury Arterial injuries n Cervical arteries Common carotid 19 Internal carotid 8 External carotid 3 Subclavian 21 Axillary 13 Vertebral 4 Internal mammary 1 Costocervical 1 Dorsal scapular 1 Mediastinal arteries Ascending and arch of aorta 5 Descending aorta 7 Innominate artery
3 Pulmonary artery 1 Total 87 Table 2: The anatomical distribution of venous injury Venous injuries n Cervical veins Internal jugular 6 Subclavian 5 Axillary 6 Mediastinal veins Pulmonary 2 Superior vena cava 1 Total 20
The anatomical basis for post-tracheotomy innominate artery
Definitive treatment options have traditionally been surgical, including ligation or reanastomosis of the innominate artery
, both of which require a sternotomy.
Proximally the aorta is transected a few millimeters above the valve commissures and distally 2 to 3 cm proximal to the innominate artery
. Horizontal mattress sutures are placed in an aorta to ventricle orientation circumferentially through the aortic valve annulus.
One of the rare complications of tracheostomy is fistula formation between the trachea and the innominate artery
. This case is being reported on account of its rarity.
For one case with left ventricular dysplasia and functional degradation, systemic-pulmonary shunt (anastomosis of innominate artery
and pulmonary artery) and pulmonary artery banding had been carried out, and Stage II ASO was performed one week later.
The tumour along with the anterior aspect of the pericardium, fastened closely with the innominate artery
and vein, left carotid artery and the arch of aorta was removed.
Pulse oximeter probe was placed on right hand so as to assess the pressure on innominate artery
during the procedure.
An aberrant right pulmonary artery (pulmonary sling) and innominate artery
compression can also cause airway narrowing.
The chimney stent in the LCCA was implanted to extend the proximal landing zone and a 42 mm x 216 mm Zenith TX2 endograft (COOK Inc., Bloomington, IN, USA) was fixed distal to the innominate artery
and completely covered the aneurysm.
In summary, subclavian steal syndrome is blood flow reversal in vertebral arteries usually caused by severe stenosis of the subclavian artery or innominate artery
. The clinical presentation of subclavian steal syndrome is variable, ranging from asymptomatic to cerebrovascular ischaemia to arm pain.
Tracheal resection and anastomosis is a technically difficult operation that carries the risk of life-threatening complications, including suture-line dehiscence, innominate artery
erosion, and wound infection.