Innominate artery rupture. A fatal complication of tracheostomy

Tracheo-innominate artery fistula is an uncommon but frequently fatal complication of tracheostomy. The case histories of three patients with tracheo-innominate artery fistula are presented, and one is a longterm survivor. The haemorrhage can be controlled by hyperinflation of the cuff of the tracheostomy tube or by direct digital compression of the artery. The damaged segment of the eroded artery should be resected and the ends oversewn. Measures to prevent this complication are described.