Truncus bicaroticus: an underestimated anatomic variation.

OBJECTIVES/HYPOTHESIS To illustrate that a truncus bicaroticus and an elongated truncus brachiocephalicus are underestimated anatomic variations; and to highlight the risk of injury of these vessel anomalies during routine surgical interventions. DATA SOURCE Report of a woman with long-term ventilation who was planned for conventional surgical tracheostomy. Due to a strong pulsatile vessel crossing the cricoid cartilage, the procedure was stopped. Further diagnostics revealed anomalies of the supraaortic vessels, including a truncus bicaroticus. CONCLUSION Anomalies of supraaortic vessels are not rare and injuries may cause severe bleeding; therefore, we recommend performing a preoperative ultrasound, particularly before starting dilatative tracheostomy.