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

Abstract

BACKGROUND AND PURPOSE:TCCFs are a common complication following craniofacial trauma and are usually treated by coils or detachable balloons. The use of the liquid embolic agent Onyx as the sole agent for the treatment of TCCFs has been rarely reported. Herein, we summarized the preliminary experience and effectiveness of treating TCCFs with Onyx in 23 patients.

Transvenous Onyx embolization of cavernous sinus dural arteriovenous fistula using a balloon catheter in the arterial side for flow control

“…Although several cases of transarterial balloon catheter-assisted Onyx embolization of traumatic carotid cavernous fistulas and of intracranial DAVFs other than CS DAVFs have been reported previously [12][13][14], ours is the first to describe the transvenous Onyx embolization of a CS DAVF using a balloon catheter on the arterial side to control flow.…”

Post-traumatic carotid-cavernous fistula with bilateral proptosis simulating cavernous sinus thrombosis

“…Trans-arterial balloon-assisted glue embolisation has been tried successfully to treat direct CCF 9. The technique of balloon angioplasty with the implantation of stents and coils can lead to the closure of the fistula in 75%–85% of cases 10. Serbinenko and, later, Debrun developed techniques for the endovascular obliteration of direct CCFs, preserving the lumen of the ICA.…”

Combined use of Onyx and coils for transarterial balloon-assisted embolization of traumatic carotid-cavernous fistulas: a report of 16 cases with 17 fistulas

“…Treatment modalities based on the exclusive use of Onyx have also recently been reported for the embolization of CCFs with promising results. All 23 cases with traumatic CCFs treated with Onyx by Yu and Huang were cured with no significant complications 3. However, the risk of Onyx reflux into the ICA as well as the overfilling of Onyx in the cavernous sinus makes this treatment method controversial.…”