# “From hero to villain” tracheovascular fistula as an unusual complication of a silicone stent in tracheal stenosis due to brachiocephalic trunk aneurysm

## TL;DR

A patient with tracheal stenosis from a brachiocephalic aneurysm developed a tracheovascular fistula after a silicone stent was placed, requiring surgical repair.

## Contribution

Highlights tracheovascular fistula as a rare but important complication of silicone stent use in tracheal stenosis caused by aneurysms.

## Key findings

- Silicone stent placement for tracheal stenosis due to a brachiocephalic aneurysm can lead to tracheovascular fistula.
- Surgical repair was necessary after stent removal to resolve the fistula.

## Abstract

Aortic and great vessel aneurysms may cause stenosis of adjacent structures, including the airway, which can be fatal if severe and may require advanced airway management.

We report a case of tracheal stenosis secondary to a brachiocephalic aneurysm that initially responded to silicone stent placement but later developed a tracheal fistula into the aneurysm. Definitive surgical repair was achieved after stent removal. This potential complication should be considered in the management of such cases.