title: Management of direct carotid-cavernous sinus fistulas with the use of ethylene-vinyl alcohol (Onyx) only: preliminary results.
abstract: OBJECTIVE
  So-called direct carotid-cavernous fistulas (CCFs) are commonly treated by detachable balloons or coils to occlude the shunt while sparing the carotid artery. Liquid embolic agents have been rarely used, and in particular, to the authors' knowledge, the use of Onyx as the sole agent has never been reported in an indexed publication.
  
  
  METHODS
  The authors describe a case series of 5 patients with posttraumatic CCF in whom embolization with Onyx was prospectively used as the sole strategy of management.
  
  
  RESULTS
  Complete occlusion was obtained at the end of the procedure in 4 cases, and the lesion in the remaining patient subsequently occluded at the 6-month follow-up evaluation.
  
  
  CONCLUSIONS
  As endovascular techniques for treatment of direct CCFs continue to evolve, this novel approach with Onyx as the sole embolic material seems promising in treating these lesions.
authors: Departamento de Terapia Endovascular Neurológica, Instituto Nacional de Neurología y Neurocirugía, Universidad Nacional Autónoma de México, Mexico City, Mexico. mazente@yahoo.com.mx
authors: Marco
authors: M
authors: Zenteno
authors: Jorge
authors: J
authors: Santos-Franco
authors: Vladimir
authors: V
authors: Rodríguez-Parra
authors: Jorge
authors: J
authors: Balderrama
authors: Yolanda
authors: Y
authors: Aburto-Murrieta
authors: Susana
authors: S
authors: Vega-Montesinos
authors: Angel
authors: A
authors: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D015901:Angiography, Digital Subtraction; D020216:Carotid-Cavernous Sinus Fistula / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D002533:Cerebral Angiography; D015331:Cohort Studies; D006259:Craniocerebral Trauma / Q000150:complications; D004121:Dimethyl Sulfoxide / Q000009:adverse effects; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000009:adverse effects; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide