Larger Sizes Matter More! Applying the Matteo Mathematics Method for Endovascular Aortic Bifurcation Reconstruction to Large Venous Vascular Repair

Matteo, Jerry; Hood, Preston; Hulsberg, Paul C; Eadie, Erik; Soule, Erik; Shabandi, Michael; Harmon, Taylor S

doi:10.7759/cureus.3537

Cited by 6 publications

(9 citation statements)

References 11 publications

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“…Matteo’s law was utilized for stent selection in order to maximize patency and prevent endoleaks and infolding. 6 Matteo et al described a formula for selection of proper stent sizes utilizing the formula to calculate the circumference of a circle ( C = π × diameter ) to represent the axial interface between the arterial intima and the vascular stent graft. For the kissing stents to assume the correct configuration within the receiving stent, an equation is constructed to solve for optimal stent diameter.…”

Section: Discussionmentioning

confidence: 99%

“…Appropriately sized stents were selected according to Matteo's law. 6,7 This formula uses the diameter of the native receiving vessel measured on cross-sectional imaging to calculate stent size to optimize patency while avoiding infolding and endoleaks. The right internal jugular vein measured 10.1 mm, the right brachiocephalic vein measured 12.1 mm, and the right subclavian vein measured 10.4 mm ( Figure 3).…”

Section: Methods/materialsmentioning

confidence: 99%

“…The right internal jugular vein measured 10.1 mm, the right brachiocephalic vein measured 12.1 mm, and the right subclavian vein measured 10.4 mm ( Figure 3). Using these measurements and Matteo's law, 6,7 appropriately sized kissing stents were selected. Two 10-mm diameter stents were determined to optimally reconstruct the confluence of the right subclavian and right internal jugular vein based on the 12-mm diameter of the receiving vessel.…”

Section: Methods/materialsmentioning

confidence: 99%

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Side-by-Side Stenting Repair of a Traumatic Pseudoaneurysm at a Venous Confluence

Dutmers

Soule

Bertran

et al. 2020

Vasc Endovascular Surg

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Objectives: The incidence and prevalence of iatrogenic vascular trauma in the United States is staggering. This has led to the advent and implementation of more efficient and effective vascular repair methods. Although open surgical repair may still be considered gold standard, new endovascular solutions have emerged as other viable options. When using an endovascular approach, proper stent sizing is vital to a successful repair. Methods: We present a case of a traumatic injury and pseudoaneurysm formation at the confluence of the right internal jugular and right subclavian veins during a central line placement. This iatrogenic pseudoaneurysm was treated with endovascular placement of side-by-side stents. A mathematical formula, which we have designated “Matteo’s law,” was utilized to select properly sized stent grafts to reconstruct the confluence and prevent infolding and endoleaks. Results: After deployment of kissing stents at the confluence of the right internal jugular and right subclavian veins, a venogram was performed, which demonstrated successful exclusion of the pseudoaneurysm and no endoleaks. Clinical follow-up confirms continued wide open flow through the reconstructed venous confluence at 8 months post-procedure. Conclusion: In reconstruction of a venous confluence, selection of properly sized stent grafts is paramount to preventing infolding and endoleaks. Matteo’s law states that the circumference of the native receiving vessel must equal the sum of the circumferences of both kissing stent grafts, subtracting the redundant material where the 2 stents interface.

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Section: Discussionmentioning

confidence: 99%

Section: Methods/materialsmentioning

confidence: 99%

Section: Methods/materialsmentioning

confidence: 99%

See 1 more Smart Citation

Side-by-Side Stenting Repair of a Traumatic Pseudoaneurysm at a Venous Confluence

Dutmers

Soule

Bertran

et al. 2020

Vasc Endovascular Surg

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“…With the many endovascular options on the market at the interventionist's disposal, careful attention to the appropriate use of these devices can lead to improved patient outcomes. One example may be operator dependent piecemeal placement of endovascular devices, utilized as a reliable method for avoiding infolding and endoleaks when reconstructing aortic bifurcations [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Covered or Not, Here I Come: Stanford Type B Aortic Dissection Repair With a Covered and Uncovered Stent Hybrid Technique

Harmon

Ghannam

Meyer

et al. 2020

Cureus

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The complications resulting from aortic dissections are often devastating. Historically, when a Stanford B aortic dissection extended into the visceral abdominal aorta, only surgical management was considered to limit visceral organ malperfusion. Complications of surgical management for Stanford B aortic dissections are as high as 50%. The inherently high complication and mortality rate for any acute aortic dissection, in addition to the complication rates resulting from surgical management, have demonstrated poor outcomes. This is especially true when aortic dissections involve the visceral segment, where thoracic endovascular aortic repair (TEVAR) becomes limited or contraindicated. In the last two decades, various approaches for TEVAR have improved in both endograft design and interventional technique. The current literature demonstrates improved outcomes for patients that receive TEVAR for Stanford B aortic dissections, including those that involve the visceral segment. Despite favorable prognostic advancement in TEVAR, the proven management complexity of Stanford B aortic dissections continue to reflect the pitfalls of the endovascular devices that are currently available. We describe a covered and uncovered stent hybrid technique in patients with complicated Stanford B aortic dissections involving the visceral segment, considering these deficiencies. Hundred percent technical success was demonstrated in the short and midterm surveillance periods.

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“…In 2018, Matteo et al described a novel method for repairing the iliocaval confluence in a trauma patient requiring covered kissing stents [10]. In this documented case, the diameter of iliac stents needed to accurately repair the venous lumens were solved based on the diameter of the native inferior vena cava.…”

Section: Introductionmentioning

confidence: 99%

When Technology Exceeds its Application: The First Reported Reconstruction of the Iliocaval Confluence Using an Aortic Endograft

Harmon

Villescas

Hood

et al. 2019

Cureus

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Severe venous dysfunction in the setting of subacute iliocaval occlusion is a high cause of morbidity and mortality in patients. Fortunately, the development of the appropriate interventional management has allowed for better patient prognosis, despite device limitations. Severe cases of venous insufficiency, anatomically challenging vasculature, and device failure remain imperative when discussing the caveats for interventional success. The current gold standard of treatment for iliocaval disease has proven to be venoplasty in conjunction with stent placement within thrombotic occlusive areas. Though intuitive for modern day interventionists, this standard is not always forthright, especially when the most prevailing interventions fail to adequately treat certain venous pathologies. In this case, interventional operators must be willing to adapt their technical proficiency and knowledge of readily available devices to successfully treat the progressive nature of venous insufficiency. The following report demonstrates an example of how an interventional operator acclimated their interventional approach to successfully treat a severe and technically challenging case of subacute iliocaval occlusion, using an aortic endograft. In this first documented deployment of an aortic endograft in an iliocaval confluence, the results show resolution of the patient’s subacute iliocaval occlusive disease, as well as complete iliocaval patency and the absence of post-procedural complications.

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Larger Sizes Matter More! Applying the Matteo Mathematics Method for Endovascular Aortic Bifurcation Reconstruction to Large Venous Vascular Repair

Cited by 6 publications

References 11 publications

Side-by-Side Stenting Repair of a Traumatic Pseudoaneurysm at a Venous Confluence

Side-by-Side Stenting Repair of a Traumatic Pseudoaneurysm at a Venous Confluence

Covered or Not, Here I Come: Stanford Type B Aortic Dissection Repair With a Covered and Uncovered Stent Hybrid Technique

When Technology Exceeds its Application: The First Reported Reconstruction of the Iliocaval Confluence Using an Aortic Endograft

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