Objective The combination of coils and Onyx for the treatment of carotid-cavernous fistulas (CCFs) is an interesting new development. The purpose of the current study is to evaluate our preliminary experience with the combined use of coils and Onyx for the treatment of traumatic CCFs.
Methods Between April 2009 and July 2014, 16 patients with 17 traumatic CCFs were embolized with the so-called ‘armored concrete’ treatment modality using coils, Onyx-18, and a non-detachable balloon via the transarterial approach. The outcomes were assessed both clinically and radiologically. Digital subtraction angiography (DSA) follow-up was performed 3 or 6 months after endovascular treatment while clinical follow-up was continued until December 2014.
Results Obliteration of the CCFs was obtained with patency of the parent artery in all 16 cases. Follow-up DSA demonstrated stable occlusion of all the fistulas. Symptoms related to the CCFs were either resolved immediately or gradually over 2 months. No worsening of the cranial neuropathies was observed during the follow-up period which averaged 32.6 months.
Conclusions The ‘armored concrete’ treatment modality using coils, Onyx, and a non-detachable balloon promises to be a safe, economical, and effective alternative in the management of traumatic CCFs.
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XZ and WG contributed equally.
Contributors XZ and WG wrote the article. RS and JPS collected the data; JY and XZC modified the manuscript. LG provided guidance. ZQC designed the proposal and interventional operation. QBZ contributed to the protocol and provided assistance with surgery.
Competing interests None declared.
Ethics approval The study was reviewed and approved by the institutional review board at Shanghai Tenth People's Hospital, Tongji University School of Medicine.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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