[Bleeding following tracheostomy: the brachiocephalic trunc].

Life threatening haemorrhage following lesions of the great supraaortic vessels has to be expected after tracheostomy in a ratio of 1:150. 0.6 to 1.1% of these lesions involve the brachiocephalic trunc. In most cases the acute haemorrhage can be controlled by hyperinflation of the cuff of the endotracheal tube. The following immediate emergency operation consists of ligature or resection of the brachiocephalic trunc. No cerebral damage is to be expected afterwards. The indication for vascular reconstruction of the trunc should be considered as a secondary matter.