Pseudoaneurysm of the right subclavian artery-tracheostomy tube as a causative factor

The subclavian artery pseudoaneurysm developing in a patient of axonal head injury triggered a search for possible causative factor. Intimacy between the aneurysm and the tracheostomy tube suggested possibility of constant irritation of subclavian artery by the tube leading to pseudoaneurysm. The hypothesis is supported by the short neck, long uncuffed tube and constant posture of the neck with absence of any other causative factor. Pseudoaneurysm was repaired without reconstruction of subclavian artery considering well developed collaterals.