{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:36:49Z","timestamp":1740166609429,"version":"3.37.3"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Indirect carotid\u2013cavernous fistulas (iCCFs) are shunts between meningeal branches of the internal carotid and\/or the external carotid arteries and the cavernous sinus. They account for 83% of all carotid\u2013cavernous fistulas (CCFs). Symptomatic iCCFs and those with increased risk of hemorrhage should be treated. Transvenous endovascular treatment is the preferred treatment modality. However, in complex cases, a combination of transarterial and transvenous approaches (multimodal treatment) is required.<\/jats:p><jats:p>\n          Methods\u2003A middle-aged woman presented with signs of increased intraocular pressure, blurry vision, diplopia, left proptosis, chemosis, conjunctival injection, ptosis, and cranial nerve VI palsy. Imaging confirmed the presence of a Barrow type D and Thomas type 4 iCCF with cortical venous reflux (CVR).<\/jats:p><jats:p>\n          Results\u2003The patient underwent transarterial and transvenous onyx embolization of the shunt, achieving a complete obliteration of the fistula. No complications occurred and the patient had a satisfactory postprocedural evolution.<\/jats:p><jats:p>\n          Conclusion\u2003Multimodal onyx embolization is an effective option for the treatment of a complex symptomatic iCCF. If CVR is identified, these lesions should be promptly treated to prevent hemorrhage secondary to rupture.<\/jats:p>","DOI":"10.1055\/s-0041-1741547","type":"journal-article","created":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T23:52:17Z","timestamp":1643068337000},"page":"483-488","source":"Crossref","is-referenced-by-count":0,"title":["Onyx Embolization of an Indirect Carotid\u2013Cavernous Fistula with Cortical Venous Reflux: Technical Note"],"prefix":"10.1055","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8465-6351","authenticated-orcid":false,"given":"Juan Felipe","family":"Abaunza-Camacho","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Research and Training in Neurosurgery (CIEN), Samaritana University Hospital, Bogot\u00e1, Colombia"},{"name":"Rosario University School of Medicine, Bogot\u00e1, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2297-9649","authenticated-orcid":false,"given":"David","family":"Vergara-Garcia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Research and Training in Neurosurgery (CIEN), Samaritana University Hospital, Bogot\u00e1, Colombia"},{"name":"Rosario University School of Medicine, Bogot\u00e1, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Humberto","family":"Madrinan-Navia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Research and Training in Neurosurgery (CIEN), Samaritana University Hospital, Bogot\u00e1, Colombia"},{"name":"Rosario University School of Medicine, Bogot\u00e1, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William Mauricio","family":"Riveros","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Research and Training in Neurosurgery (CIEN), Samaritana University Hospital, Bogot\u00e1, Colombia"},{"name":"Rosario University School of Medicine, Bogot\u00e1, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Caballero","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Research and Training in Neurosurgery (CIEN), Samaritana University Hospital, Bogot\u00e1, Colombia"},{"name":"Rosario University School of Medicine, Bogot\u00e1, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,1,24]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/B978-0-444-63640-9.00009-6","article-title":"Epidemiology, clinical presentation, diagnostic evaluation, and prognosis of cerebral dural arteriovenous fistulas","volume":"143","author":"M S Elhammady","year":"2017","journal-title":"Handb. 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