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All Journal Journal of Neurointervention and Stroke (JNeViS)
Merlin Prisilia Kastilong
Neuro Center, PELNI Hospital, Jakarta
Medicine & Pharmacology Neuroscience

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Manual Compression Variations (Fingers vs. Fingers Assisted by Fist) and Hematoma Incidence Following Cerebral Angiography Fritz Sumantri Usman; Andrianor Rahman; Alfi Rizky Medikanto; Engki Irawan; Agus Budi Bowo Leksono; Merlin Prisilia Kastilong; Leny Kurnia
Journal of Neurointervention and Stroke Vol. 2 No. 1: MAY 2026
Publisher : Neurointervention Working Group of Indonesian Neurological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63937/jnevis-2026.21.28

Abstract

Highlight: The FAbf technique reduced the incidence of puncture-site hematoma FAbF is an independent protective factor against hematoma ABSTRACT Introduction: Complications at the femoral access site remain a significant clinical challenge following cerebral angiography. The most common complication is an access-site hematoma resulting from inadequate hemostasis after sheath removal. Evaluating different manual compression techniques is essential to optimize bleeding control and improve patient safety. Objective: This study compared the effectiveness of standard finger compression (FC) versus the fingers-assisted-by-fist (FAbF) technique on post-procedural hematoma incidence. Method: In this single-center randomized controlled trial, 150 adult patients at PELNI Hospital, Jakarta, were allocated into two equal groups: FC (control, n=75) or FAbF (intervention, n=75). Hematoma occurrence was evaluated after sheath removal. Data were analyzed using Chi-square/Fisher’s exact tests and multivariate binary logistic regression. Result: Puncture-site hematomas occurred in 17 cases overall, with a significantly higher incidence in the FC group than the FAbF group (13 vs. 4 patients; p = 0.02; OR = 3.72; 95% CI: 1.15–12.01). Bivariate analysis also showed an association between pre-procedural antiplatelet therapy and an increased risk of hematoma (p = 0.043). Multivariate logistic regression confirmed that the compression technique was the sole independent predictor of hematoma formation; patients undergoing conventional FC were significantly more likely to develop a hematoma than those receiving FAbF (p = 0.014; aOR = 4.62; 95% CI: 1.36–15.75). Conclusion: The FAbF technique is significantly more effective than the conventional FC technique at reducing hematoma incidence following cerebral angiography with femoral access.
Indonesian Stroke Management Neurointerventional Services Challenges Fritz Sumantri Usman; Achmad Firdaus Sani; Fitri Octaviana; Merlin Prisilia Kastilong; Leny Kurnia; Theodorus K Hendartono; Andika S Atmadja; Yan Leo Tambunan; Syahrul Syahrul; Dodik Tugasworo Pramukarso
Journal of Neurointervention and Stroke Vol. 1 No. 1: MAY 2025
Publisher : Neurointervention Working Group of Indonesian Neurological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63937/jnevis-2025.11.3

Abstract

Highlight: Stroke burden in Indonesia Challenges for Indonesian neurointerventionst ABSTRACT Introduction: Stroke is a leading cause of death and disability in Indonesia. Currently, stroke management has become more aggressive, and neurointerventionists are required to optimize acute stroke management. Objective: To determine the distribution of neurointerventionists in Indonesia and identify the obstacles faced in neurointervention services. Method: This cross-sectional study used an online questionnaire distributed to neurointerventionists in Indonesia between October and November 2024. Result: A total of 105 neurointerventionists completed the questionnaires. The distribution of neurointerventionists remains concentrated in Java, especially in Jakarta. The highest ratio of neurointerventionists to stroke cases was observed in Jakarta, while the lowest was in Lampung. West Java identified the largest gap in the number of neurointerventionists compared to Jakarta. Notably, 20.9% of neurointerventionists had not performed any neurointerventional procedures, and 46.8% reported challenges related to the funding of neurointerventional procedures through government insurance. Conclusion: Despite the increasing number of neurointerventionists in Indonesia, their distribution remains concentrated in Java. The main barrier was the funding of neurointerventional procedures through government insurance.
Improvement of Hemifacial Spasm Following Palliative Embolization of an Unruptured Cerebellar Arteriovenous Malformation Merlin Prisilia Kastilong; Fritz Sumantri Usman; Achmad Firdaus Sani; Gilang Nispu Saputra; Octavianus Darmawan; Rahmi Muin; Leny Kurnia; Erman Keneddy
Journal of Neurointervention and Stroke Vol. 1 No. 1: MAY 2025
Publisher : Neurointervention Working Group of Indonesian Neurological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63937/jnevis-2025.11.6

Abstract

Highlight: Cerebellar region's AVM and hemifascial spasm Embolization AVM and hemifacial spasm ABSTRACT Introduction: Posterior fossa arteriovenous malformations (AVMs) are uncommon, accounting for 7–15% of all intracranial AVMs. These malformations typically present with symptoms such as headaches, seizure, and intracerebral hemorrhage. Reports of hemifacial spasm–characterized by involuntary contractions of the facial muscles–as a presenting symptom of AVMs are extremely rare and usually occur only when the facial nerve is compressed. Case: A 35-year-old male presented with worsening left-sided hemifacial spasm, unresponsive to medication for around one year, followed by progressive headache and dizziness. T2-weighted MRI revealed contact between the facial nerve root and a tortuous posterior inferior cerebellar artery (PICA), along with an AVM in the left cerebellar hemisphere. Cerebral angiography demonstrated a left cerebellar AVM with feeding arteries from superior cerebellar artery (SCA) and PICA. The patient underwent successful embolization of the SCA using glue (n-BCA:lipiodol). An intraprocedural thrombus developed but was managed appropriately. Post-procedural cerebral angiography revealed recanalization of the basilar artery and left PICA, with a 30% reduction in nidus size. The hemifacial spasm improved significantly after embolization with an HFS-7 score reduction of six points in the first week post-procedure. Conclusion: Palliative embolization has shown potential in alleviating symptoms associated with hemifacial spasm and improving quality of life. Careful patient selection is essential to rule out secondary causes of hemifacial spasm and to identify underlying neurovascular contacts.
Co-Authors Achmad Firdaus Sani, Achmad Firdaus Agus Budi Bowo Leksono Alfi Rizky Medikanto Andika S Atmadja Andrianor Rahman Dodik Tugasworo Pramukarso Engki Irawan Erman Keneddy Fitri Octaviana Fritz Sumantri Usman Gilang Nispu Saputra Leny Kurnia Octavianus Darmawan Rahmi Muin Syahrul Syahrul Theodorus K Hendartono Yan Leo Tambunan