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.

中文翻译：

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静脉汇合处创伤性假性动脉瘤的并排支架修复

目的：在美国，医源性血管创伤的发生率和患病率是惊人的。这导致了更有效和更有效的血管修复方法的出现和实施。尽管开放式手术修复可能仍被视为黄金标准，但新的血管内解决方案已成为其他可行的选择。使用血管内方法时，适当的支架尺寸对于成功修复至关重要。方法：我们介绍了一例在中心线放置期间在右颈内静脉和右锁骨下静脉汇合处形成的外伤和假性动脉瘤。这种医源性假性动脉瘤通过血管内放置并排支架进行治疗。一个数学公式，我们称之为“马泰奥定律，”用于选择适当尺寸的支架移植物以重建汇合处并防止内折叠和内漏。结果：在右颈内静脉和右锁骨下静脉汇合处放置接吻支架后，进行了静脉造影，结果显示成功排除了假性动脉瘤并且没有内漏。临床随访证实在术后 8 个月通过重建的静脉汇合处继续大开血流。结论：在静脉汇合处的重建中，选择合适尺寸的覆膜支架对于防止内折和内漏至关重要。Matteo 定律指出，天然接受血管的周长必须等于两个接吻支架移植物的周长之和，减去两个支架交界处的多余材料。