Tracheostomy with aortic debranching: a case report

Percutaneous dilatational tracheostomy (PDT) is preferred over conventional surgical tracheostomy for prolonged airway protection and mechanical ventilation. However, despite its advantages, severe PDT-related complications have been reported, including catastrophic hemorrhage from common carotid artery laceration and innominate artery pseudo-aneurysm. PDT can typically be applied to the trachea, which is the focal point for the transverse course of great vessels (e.g., the anomalous brachiocephalic trunk, which overlaps with the targeted lesion anteriorly); therefore, to improve patient outcomes, an alternative method using aortic debranching may be considered.