It depends upon the indication. and the anatomical landmark disturbance. With any type of airway obstruction an open tracheostomy under local anesthetic is the safest option. If the patient is already intubated then care needs to be taken with respect to the location of the great vessels during perc tracheostomy
yes it depends on the anatomy but I think percutanous is less invasive than open traditional one if you can use any guiding tool . Entubated patient my be more easier as the tube make use of guiding tools more helpfull