Symptoms include hemoptysis, and/or massive hemorrhage which result from the formation of a fistula between the trachea and the brachiocephalic artery. The primary threat is respiratory compromise leading to dyspnea and cyanosis. Patients can later present with hypovolemic shock which include symptoms of tachycardia, cyanosis, cold and clammy skin, dizziness, confusion, and fatigue. Patients may also develop sepsis. Causes == The innominate artery usually crosses the trachea at the ninth cartilage ring, however this can vary from the sixth to the thirteenth cartilage ring in patients. A<unk>  runs between the trachea and the innominate artery. Through this connection blood from within the artery may pass into the trachea or alternatively air from within the trachea may cross into the artery.<unk>  is a late complication of a tracheotomy and is associated with prolonged endotracheal intubation, as a result of cuff over inflation or a poorly positioned tracheostomy tube. Over inflation of the cuff causes the tracheostomy tube to erode into the posterior aspect of the innominate artery leading to the formation of a fistula. The pathogenesis of an<unk>  by the aforementioned method is pressure necrosis by tracheostomy tube on the tracheal wall. An<unk>  can also occur due to innominate artery injury as a result of an bronchoscopy. Patients whose tracheotomies are placed beneath the third tracheal ring cartilage and patients with innominate arteries crossing higher on the trachea have an increased risk of developing an<unk> . Other factors contributing to the development of<unk>  include steroids, which weaken the endotracheal mucosa, episodes of hypotension in which the pressure in the tracheostomy tube exceeds that of the endotracheal mucosa, and radiation therapy. An endotracheal tumor can mimic a<unk>  and present with massive bleeding during a rigid bronchoscopy.
Tracheoinnominate fistula
Tracheoesophageal fistula
Laryngotracheal stenosis
Tracheal deviation
Subglottic stenosis
Tracheal tumor
Aortoesophageal fistula
Bronchopleural fistula