Management of tracheoinnominate artery fistula.

TIF is a rare and often fatal complication of tracheostomy. Bleeding from the trachea after tracheostomy demands urgent investigation. Bronchoscopy is the diagnostic procedure of choice. Bedside control of hemorrhage by cuff overinflation or digital arterial compression can be lifesaving. Prompt operation with division of the innominate artery and separation of the trachea from the divided artery by viable tissue is indicated. Neurologic complications are rare.