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Nonsurgical Treatment of Tracheoinnominate Fistula in the Pediatric Population
Arjun S. Joshi, MD;
Neil Tanna, MD;
Charles A. Elmaraghy, MD;
Izi Obokhare, MD;
Todd A. Ponsky, MD;
Maria T. Pena, MD;
Michael C. Slack, MD
Arch Otolaryngol Head Neck Surg. 2007;133(3):294-296.
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INTRODUCTION
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.
REPORT OF A CASE
A 10-year-old girl with profound developmental delay, cerebral palsy, and epilepsy was transported to our institution by helicopter after experiencing an episode of massive hemorrhage from the tracheostomy tube. The patient . . . [Full Text of this Article]
COMMENT
AUTHOR INFORMATION
Author Affiliations: Division of Otolaryngology–Head and Neck Surgery, The George Washington University, Washington, DC (Drs Joshi and Tanna); Department of Otolaryngology, Ohio State University, Columbus (Dr Elmaraghy); and Departments of Pediatric Surgery (Drs Obokare and Ponsky) and Otolaryngology (Dr Pena) and Children's National Heart Institute (Dr Slack), Children's National Medical Center, Washington, DC.
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