Management of direct carotid-cavernous sinus fistulas with the use of ethylene-vinyl alcohol (Onyx) only: preliminary results

Abstract

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.

Use of Onyx for Transarterial Balloon-Assisted Embolization of Traumatic Carotid Cavernous Fistulas: A Report of 23 Cases

“…The use of Onyx as the sole embolic agent for TCCFs has been rarely reported. 1,2 In this article, we report our preliminary experience of the use of Onyx for TCCFs in 23 patients.…”

Endovascular Modalities for the Treatment of Cavernous Sinus Arteriovenous Fistulas: A Single-Center Experience

“…The cost of Onyx use is lower compared to conventional coiling whether it is used with coiling or as a sole treatment option. 27,32,46,[51][52][53][54] Onyx can be used as a sole agent for embolization in case of low-flow fistulas or with detachable coils as shown in our cases. 25,27,32,52 It can be delivered either transarterially or transvenously; its nonadhesive property eliminates the risk of gluing the microcatheter and can permit prolonged injections with penetration into different areas of the CS as well as the draining vein and branches of other arterial feeders, which cannot be sometimes reached by the standard catheter/ coiling technique.…”

Traumatic Middle Meningeal Artery and Fistula Formation with the Cavernous Sinus and a Review of the Literature on Endovascular Management of Traumatic Carotid Cavernous Fistulas

“…It is also technically easier to guide a microcatheter and microguidewire combination through a small fistula than a balloon. Transarterial NBCA or ONYX embolization of TCCFs has been reported to be an efficient treatment for TCCFs when a trans arterial detachable balloon or GDC fails to seal the fistula; this procedure has the advantage of being relatively easy to deliver through a microcatheter, producing rapid induction of thrombosis and permanent occlusion after polymerization or solidification [26][27][28].…”