Ultrasound and three-dimensional image reconstruction angio-computed tomography scan for hybrid surgical tracheostomy in patient with abnormal neck vascularization

Percutaneous dilatational tracheostomy is a common and safe ICU procedure. However, neck anatomy variations can cause bleeding. Pre-procedural ultrasound should be carried out to detect abnormalities in neck structures. A 3D image reconstruction angio-computed tomography scan of the epiaortic vessels should be performed for precise planning of actions. We describe a hybrid tracheostomy technique required following an anomalous vascularization of the neck discovered preoperatively by echography and imaging method.