title: Carotid-cavernous fistula treatment with ethylene vinyl alcohol (onyx) exclusively through anterior venous approach.
abstract: The type of venous drainage of a direct carotid-cavernous fistula is an important issue to consider for the endovascular therapeutic decision. In case of an inadequate posterior drainage associated with a good anterior drainage, the facial vein is a useful alternative. The exclusive embolization with ethylene vinyl alcohol (EVOH Onyx), arterial and/or venous via the internal carotid artery (ICA) occlusion has been used successfully, in a few cases until now. Nevertheless, the use of this method through anterior transvenous approach has not been previously described. Presented here is the case of a 13-year-old female patient with left posttraumatic carotid-cavernous fistula, with predominant anterior drainage, as well as carrier of traumatic occlusion of the contralateral ICA. The treatment was by means of a transvenous approach with transient occlusion of the left ICA.
authors.affiliation: Department of Neurosurgery, La Raza National Medical Center, Instituto Mexicano del Seguro Social, Universidad Nacional Autónoma de México, Mexico. jasantosfranco@hotmail.com
authors.forename: J A
authors.initials: JA
authors.lastname: Santos-Franco
authors.forename: A
authors.initials: A
authors.lastname: Lee
authors.forename: M
authors.initials: M
authors.lastname: Zenteno
authors.forename: C
authors.initials: C
authors.lastname: Gil-Ortiz
authors.forename: S
authors.initials: S
authors.lastname: Vega-Montesinos
mesh_terms: D000293:Adolescent; D021721:Balloon Occlusion; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000503:physiopathology; D020216:Carotid-Cavernous Sinus Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D002533:Cerebral Angiography / Q000379:methods; D003097:Collateral Circulation; D006259:Craniocerebral Trauma / Q000150:complications*; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D011145:Polyvinyls / Q000008:administration & dosage*; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide