A Case of Tracheo-brachiocephalic Artery Fistula: Accidental Interruption of Cerebral Blood Flow following Ligation of the Brachiocephalic Artery

A 7-year-old boy with tracheo-brachiocephalic artery fistula underwent ligation of the brachiocephalic artery. The left common carotid artery and subclavian artery were accidentally ligated together with the brachiocephalic artery during the procedure. Interruption of the left subclavian artery was found by disappearance of waves in the recordings of a pulse oximeter attached to the left middle finger and in the recordings of left radial artery pressure. Interruption of cerebral blood flow was found by loss of palpability of the left common carotid artery. Attention needs to be paid to the blood flow of the left common carotid artery in ligation of the brachiocephalic artery. It is necessary to palpate the left common carotid artery, set a pulse oximeter on the left ear and observe pupil size.