DISCUSSION: Our patient had an unusual cause of tracheal stenosis due to an anomaly known as a bovine arch where the innominate artery shares a common origin with the left common carotid artery. Vascular anomolies can cause a myraid of airway disorders including extrinsic compression of central airways1. In our case, stenosis was successfully and safely managed with a removable silicone stent. These stents are durable, inexpensive, and easy to remove. Deployment requires rigid bronchoscopy with general anesthesia. Hybrid metallic stents are flexible, rarely migrate, and may be deployed through flexible bronchoscopy. However, they carry a theoretical risk of producing more granulation tissue than silicone stents making removal challenging. For these reasons, we chose to use a silicone stent for our patient as a temporizing measure given plan for definitive surgical correction of the innominate artery. After surgical correction the silicone stent was no longer needed and easily removed during repeat rigid bronchoscopy.