A tracheo-innominate fistula is a rare but life-threatening complication of tracheostomy and has a mortality rate of 100% without therapy. The underlying cause is an acquired fistula between the brachiocephalic trunk and the trachea, induced by a tracheostomy cannula’s mechanical impact. A 25-year-old female was admitted with pulsatile bleeding from a tracheostomy. The cause of the bleeding was a tracheo-innominate artery fistula, which was difficult to recognize. Said fistula was treated with implantation of a self-expanding stent-graft. The bleeding stopped immediately after the implantation of the stent-graft. Dual antiplatelet medication with aspirin IV and ticagrelor PO, bridged with a bolus of eptifibatide IV, was started right after the stent deployment. Endovascular self-expanding stent-graft implantation is a viable treatment option for tracheo-innominate artery fistulae, especially in hemorrhagic emergencies.

中文翻译：

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气管无名瘘管：长期气管切开术后因气管无名的动脉瘘引起的急性出血和低血容量性休克，采用支架移植治疗

无气管瘘是一种罕见但危及生命的气管造口术并发症，未经治疗死亡率为100％。根本原因是气管造口术插管的机械冲击引起的臂头干和气管之间的后天性瘘管。一名25岁女性因气管切开术而出现搏动性出血。出血的原因是难以识别的气管无名动脉瘘。所述瘘管通过植入自扩张支架移植物进行治疗。植入支架后，出血立即停止。支架部署后，即刻开始使用阿司匹林IV和替格瑞洛PO双重抗血小板药物，并与eptifibatide IV推注桥接。