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Journal of Neurointervention and Stroke (JNeViS)
Published by Perhimpunan Dokter Spesialis Neurologi Indonesia
ISSN : -     EISSN : 31236227     DOI : https://doi.org/10.63937/jnevis-2025.12.12
Core Subject : Health, Science,
Medicine & Pharmacology Neuroscience
Journal of Neurointervention and Stroke (JNeViS) is a peer-reviewed journal dedicated to publishing clinical, epidemiological, basic science, and translational research in vascular and interventional neurology. The journal also welcomes contributions on other neurological and neurosurgical conditions that may benefit from minimally invasive and innovative approaches across specialties such as Neurology, Radiology, and Neurosurgery. Suitable submissions for this Journal include Original Article (observational studies, clinical trials, epidemiological research, health services and outcomes studies, basic and translational research, and innovative techniques in vascular and interventional neurology), and Case Reports or Case Series.
Arjuna Subject : Kedokteran - Neurologi Klinis
Articles 22 Documents
 1   2   3 
Funduscopic and Transcranial Doppler Profile of the Ophthalmic Artery in Stroke Patients with Hypertensive Retinopathy Adriani, Dini; Dewati, Eva; Sitorus, Freddy; Ariani, Ni Nengah Rida; Diafiri, Dinda; Kasih, Tiara; Kurniawan, Mohammad
Journal of Neurointervention and Stroke Vol. 1 No. 2: NOVEMBER 2025
Publisher : Neurointervention Working Group of Indonesian Neurological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63937/jnevis-2025.12.12

Abstract

Highlight: Hypertensive retinopathy may predict stroke risk TCD may complement funduscopy in stroke with HR ABSTRACT Introduction: Hypertensive retinopathy (HR) is a manifestation of chronic vascular damage and is increasingly recognized as a predictor of stroke. Funduscopy and Transcranial Doppler (TCD) examination of the ophthalmic artery may offer non-invasive insight into cerebrovascular health. Objective: To describe the demographic, funduscopic, and ophthalmic artery hemodynamic profiles in stroke patients with hypertensive retinopathy using Transcranial Doppler. Method: A cross-sectional descriptive study was conducted from May 2022 to May 2025 at Cipto Mangunkusumo National Hospital, involving 67 ischemic stroke patients with HR. Retrospective data were collected from medical records, including sociodemographics, fundus classification based on Wong and Mitchell, and Pulsatility Index (PI) values of the ophthalmic artery from TCD. Result: Mild hypertensive retinopathy is prevalent in ischemic stroke patients, and elevated ophthalmic artery PI values are suggestive of small-vessel disease. Conclusion: Funduscopy and TCD can be complementary tools in evaluating stroke risk in hypertensive.
Profile of Acute Ischemic Stroke Patients Receiving Intravenous Thrombolysis with Recombinant Tissue Plasminogen Activator at Soeradji Tirtonegoro Hospital Mianoki, Adika; Wiati, Fatikha Fajar; Salsabila, Hanum
Journal of Neurointervention and Stroke Vol. 1 No. 2: NOVEMBER 2025
Publisher : Neurointervention Working Group of Indonesian Neurological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63937/jnevis-2025.12.13

Abstract

Highlight: Most patients showed early neurological improvements after IV thrombolysis The door-to-needle time was  longer than the recommended guidelines A patient profile may guide the optimization of stroke management ABSTRACT Introduction: Acute ischemic stroke is a leading cause of mortality and disability worldwide, including in Indonesia. Intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) is recommended for eligible patients, but data from Indonesian referral hospitals remain limited. Objective: This study aimed to describe the demographic characteristics, treatment times, and in-hospital clinical measures of patients with acute ischemic stroke receiving intravenous rtPA at Soeradji Tirtonegoro Hospital. Method: A descriptive study analyzed medical records of patients treated with intravenous rtPA between April 2022 and August 2024. Collected variables included age, sex, stroke onset, onset-to-needle time (OTN), vital parameters, comorbidities, door-to-imaging (DTI),  door-to-needle (DTN) times, early ischemic change (EIC), National Institutes of Health Stroke Scale (NIHSS) scores at admission, at 24 hours, and at discharge, Barthel Index at admission and discharge, early neurological improvement (ENI), early neurological deterioration (END), symptomatic intracerebral hemorrhage (sICH), in-hospital mortality, and length of stay (LOS). Result: Most patients were older males (62.2%; median age 62 years). Hypertension was the most common comorbidity, followed by diabetes mellitus and dyslipidemia. The median onset-to-needle time (OTN) was 240 minutes, and 80% achieved a DTI time within 25 minutes. The median DTN time was 80 minutes. Median NIHSS scores improved from 11 on admission to 6 at 24 hours and four at discharge, with ENI in 64.44% and early END in 15.56% of patients. The Barthel Index increased from 3 to 20 during hospitalization. Symptomatic intracerebral hemorrhage occurred in 6,.67%, and in-hospital mortality was 17.78 %. Conclusion: Intravenous rtPA thrombolysis improved neurological and functional measures among acute ischemic stroke patients. However, the prolonged door-to-needle time indicates the need for enhanced in-hospital workflows to accelerate treatment delivery.
Enhancing Stroke Risk Prediction with Explainable AI: Leveraging Resampling and Machine Learning for Improved Accuracy Mahin, Minhazul Alam; Islam, Md. Mominul; Alam, Md. Zulfikar; Pollob, Arnob Dutta; Zaman, Oxita
Journal of Neurointervention and Stroke Vol. 1 No. 2: NOVEMBER 2025
Publisher : Neurointervention Working Group of Indonesian Neurological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63937/jnevis-2025.12.16

Abstract

Highlight: Advanced resampling techniques improved class balance in stroke datasets Gradient Boosting with SMOTE reached 92% accuracy with SHAP interpretability ABSTRACT Introduction: Stroke represents a significant global health concern, impacting millions worldwide and contributing substantially to morbidity and mortality. Early detection and accurate risk prediction remain critical for effective prevention strategies. Objective: This study aimed to improve stroke risk prediction by employing machine learning algorithms on health survey data to identify key predictors and enhance predictive performance. Method: A dataset derived from the National Health and Nutrition Examination Survey, comprising 4,603 participants, was utilized. The dataset exhibited class imbalance, with only 7.86% of individuals diagnosed with stroke. To address this imbalance, advanced resampling techniques, including SMOTE, SMOTETomek, and ADASYN, were applied. A range of tree-based algorithms was implemented, including Gradient Boosting, AdaBoost, XGBoost, and a Voting Classifier integrating Decision Tree, AdaBoost, and Gradient Boosting classifiers. Model evaluation included accuracy and AUC scores. Explainable Artificial Intelligence (XAI) analyses were conducted using SHAP (SHapley Additive exPlanations) to interpret feature importance. Result: The Gradient Boosting classifier, in conjunction with SMOTE, achieved the highest performance with an accuracy of 92% and an AUC score of 0.70. SHAP analysis identified age, general health condition, marital status, and BMI as the most influential predictors of stroke risk. Conclusion: This study underscores the essential need for ongoing advancements in early stroke detection methodologies. The findings highlight the transformative potential of machine learning and XAI in predictive healthcare, offering valuable insights for stroke prevention strategies.
Profile of Non-Hemorrhagic Stroke Patients Who Received Endovascular Stenting Services at Dr. Kariadi General Hospital Semarang Aritonang, Freddy Hasudungan; Kurnianto, Aditya; Andhitara, Yovita
Journal of Neurointervention and Stroke Vol. 1 No. 2: NOVEMBER 2025
Publisher : Neurointervention Working Group of Indonesian Neurological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63937/jnevis-2025.12.17

Abstract

Highlight: This study describes profiles of patients who received endovascular stenting services A descriptive method study was selected to offer a thorough overview ABSTRACT Introduction: Endovascular stenting (ES) is an alternative therapy to carotid endarterectomy (CEA) and best management therapy (BMT) for intracranial and extracranial arterial stenosis with or without symptoms. Atherosclerosis can cause non-hemorrhagic stroke, and the risk factors include diabetes mellitus, dyslipidemia, smoking, hypertension, and advanced age. Objective: This study aimed to determine the profile of non-hemorrhagic stroke patients who received ES services at Dr. Kariadi General Hospital, Semarang. Method: This research used a descriptive method with sampling carried out sequentially using electronic patient medical record data from January 2023 to November 2024. Result: ES services were obtained for 67 patients, of whom 39 were men (58.2%). The largest age groups were between > 50-60 years and > 60-70 years, accounting for 37.3%. The stenosis in the proximal vertebral artery was performed by ES in 70.1% patients. ES was performed on 62.7% patients, with an average stenosis degree of 59.8% in the 50%–69% range (moderate to severe stenosis group). Risk factors for atherosclerosis in this study included hypertension in 67.2% patients and dyslipidemia in 52.2%. There were 71.6% of patients who did not have risk factors for diabetes mellitus. In this study, only 2 patients’ data from medical records were examined for smoking risk factors. Conclusion: Non-hemorrhagic stroke patients who received endovascular stenting services at Dr. Kariadi General Hospital, Semarang, were men in their 50s and 60s, with lesions in the proximal vertebral artery with an average stenosis degree of 59.8%. Risk factors included hypertension, age, and dyslipidemia.
Endovascular Stenting for Chronic Headache Secondary to Cerebral Venous Sinus Stenosis: A Case Report Hakim, Izza Ayudia; Dermawan, Bagus; Zhang, Yingying; Zhang, Guangzheng
Journal of Neurointervention and Stroke Vol. 1 No. 2: NOVEMBER 2025
Publisher : Neurointervention Working Group of Indonesian Neurological Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.63937/jnevis-2025.12.20

Abstract

Highlight: CVSS is an underdiagnosed but reversible cause of chronic headache Venous stenting effectively restores venous outflow and reduces ICP Early recognition and intervention lead to rapid and sustained symptoms resolution ABSTRACT Introduction: Chronic headache poses a significant diagnostic and therapeutic challenge. Cerebral venous sinus stenosis (CVSS) is an underrecognized yet important etiology in which stenosis impairs venous outflow and elevates intracranial pressure, leading to headache. Endovascular stenting offers a therapeutic approach by mechanically restoring venous flow. Case: A 43-year-old female presented with a chronic headache for 3 months, refractory to multimodal medical therapy. Digital subtraction angiography (DSA) confirmed stenosis in the bilateral transverse sinuses. The patient subsequently underwent successful endovascular venous stenting. Conclusion: This case underscores that CVSS is a potentially treatable cause of chronic headache. Endovascular intervention can provide rapid symptomatic relief for patients with medically refractory headache secondary to venous sinus stenosis. Long-term follow-up remains essential to confirm sustained benefit.
Two Strikes in the Cath Lab: Lessons from Repeat Aneurysm Ruptures During Endovascular Treatment Vita Kusuma Rahmawati; Achmad Firdaus Sani; Dedy Kurniawan; Faishol Hamdani; Muh. Wildan Yahya
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-2026.21.19

Abstract

Highlight: Repeat aneurysm rupture during endovascular therapy is rare but often fatal This case highlights the need for careful hydrocephalus management and monitoring Dynamic neurological assessment guides urgent aneurysm repair and improves outcomes ABSTRACT Introduction: Repeat aneurysmal rupture in the catheterization laboratory remains a critical concern, with periprocedural mortality rates reported as high as 63%. Such rebleeding requires rapid multidisciplinary decision-making, particularly in high-grade aneurysmal subarachnoid hemorrhage (aSAH) complicated by hydrocephalus. Case: A 56-year-old hypertensive man presented with sudden-onset headache followed by loss of consciousness (Hunt and Hess grade III). Computed tomography (CT) revealed subarachnoid and intraventricular hemorrhage, and CT angiography identified a left saccular posterior communicating artery aneurysm. During induction in the catheterization laboratory, he developed severe headache, seizures, hypertension, and pupil anisocoria, raising concern for impending cerebral herniation. Owing to a postictal comatose state, his clinical Hunt and Hess grade deteriorated to grade V. Emergent CT confirmed acute hydrocephalus and rebleeding. Endovascular coiling was deferred, and an external ventricular drain was placed, resulting in improved consciousness. Subsequent angiography demonstrated contrast extravasation from the aneurysm dome, confirming rebleeding. The aneurysm ruptured three times over two weeks, including twice during separate catheterization laboratory sessions. Definitive endovascular coiling ultimately achieved near-complete aneurysm packing. Neurological status improved to Hunt and Hess grade II, followed by ventriculoperitoneal shunt placement. At discharge, the modified Rankin Scale score improved from 4 to 3 without new focal neurological deficits. Three-month follow-up confirmed stable neurological recovery. Conclusion: This case highlights the challenges of repeated aSAH rupture in the catheterization laboratory, emphasizing hydrocephalus management and dynamic Hunt and Hess grading to guide aneurysm treatment timing. Urgent endovascular coiling may be warranted despite clinical instability, using individualized strategies to optimize neurological outcomes.
Distal Transradial Access for Cerebral Digital Subtraction Angiography: A Case Report on Advantages, Limitations, and Practical Insights Fritz Sumantri Usman; Asep Muhajirin; Evlyne Erlyana Suryawijaya; Gamaliel Wibowo Soetanto
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-2026.21.22

Abstract

Highlight: dTRA is a safe alternative to TRA with ergonomic benefits in selected anatomy Careful technique is required in dTRA to avoid snuffbox-related complications dTRA enables effective cerebral angiography with fast hemostasis and artery preservation ABSTRACT Introduction: Transradial access (TRA) has showed substantial advantages over transfemoral access (TFA), including decreased morbidity and mortality and increased patient comfort, resulting in its widespread usage. The distal transradial approach (dTRA) offers advantages such as better radial artery preservation, improved ergonomics, and a lower risk of hand ischemia, with early studies reporting high technical success and few complications. In neurointervention, dTRA is emerging as an alternative for cerebral angiography, providing greater patient comfort, fewer access-site complications, and shorter hemostasis times, although evidence remains limited. Case: A 45-year-old man underwent cerebral digital subtraction angiography (DSA) using distal transradial access to further evaluate suspected bilateral middle cerebral artery thrombosis. Conclusion: Appropriate patient selection for dTRA requires careful consideration of both suitability for radial access and anatomical factors, as dTRA may be preferred in certain clinical scenarios, but caution is necessary to avoid injury to surrounding structures in the anatomical snuffbox. For diagnostic cerebral angiography, dTRA demonstrates favorable procedural success with improved safety and patient comfort; however, further studies are required to support its wider application in neurointervention.
Dual-Balloon–Assisted Coil–Onyx Embolization with Intraprocedural Management of Onyx Reflux for a High-Flow Direct Carotid–Cavernous Fistula: A Technical Case Report Yahya Assegaff; Erwin Hardiansyah; Rani Kerinciani Adam; Zhongwei Xu; Kai Qiu; Linbo Zhao; Sheng Liu
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-2026.21.23

Abstract

Highlight: Proximal BGC inflation enables superselective angiography to localize the fistula Distal ICA balloon blocks antegrade flow, reducing the risk of Onyx reflux Proximal BGC arrests Onyx reflux and enables aspiration to preserve ICA patency ABSTRACT Introduction: High-flow direct carotid–cavernous fistulas (CCFs) are most commonly caused by traumatic injury to the cavernous segment of the internal carotid artery (ICA). During balloon-assisted coil–Onyx embolization, reflux of Onyx into the ICA remains a persistent technical challenge, as it carries a risk of intracranial arterial occlusion and potentially severe neurological sequelae. Case: A 58-year-old man came with progressive right-sided proptosis, chemosis, orbital bruit, and diplopia following head trauma. Digital subtraction angiography (DSA) confirmed a high-flow traumatic direct CCF (Barrow Type A). Dual-Balloon flow control was performed using a distal ICA protective balloon positioned across the fistulous orifice and a proximal balloon guide catheter (BGC) placed in the cervical ICA. Coil framing was performed, followed by controlled injection of Onyx-18. Minor Onyx reflux into the ICA was managed by BGC inflation to arrest antegrade flow, thereby preventing intracranial embolization, and aspirating the refluxed Onyx via an intermediate catheter. Final angiography demonstrated complete fistula occlusion with preserved ICA flow, and symptoms improved significantly within 48 hours. Conclusion: Dual-balloon-assisted coil–Onyx embolization represents an effective reconstructive strategy for high-flow direct CCFs, particularly in mitigating the risk of Onyx reflux. The proximal BGC serves as a critical "safety net": in the event of reflux, its inflation prevents embolic migration into the intracranial circulation and allows targeted aspiration of refluxed Onyx. To our knowledge, this represents the first reported use of this dual–balloon–assisted coil–Onyx embolization technique for high-flow direct CCF at our center.
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.
Occupational Health Profile of Neurointerventionists in Indonesia: A National Cross-Sectional Survey Study Fritz Sumantri Usman; Merlin Prisillia Kastilong; Leny Kurnia; Hugo Dwiputra Wiradarma; Petrus Nilwan Ginting; Bambang Sutrisno; Evlyne Erlyana Suryawijaya
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-2026.21.30

Abstract

Highlight: First national survey of neurointerventionists in Indonesia Fatigue, sleep disturbance, and musculoskeletal pain were common Radiation monitoring and occupational protection remin limited ABSTRACT Introduction: Neurointerventional practice may increase the risk for musculoskeletal problems, fatigue, and sleep disturbance due to prolonged radiation exposure, physical strain, and irregular working hours. However, data from developing countries remains limited. Objective: This study aimed to provide information and analyze the occupational health profile and associated risk factors among neurointerventionists in Indonesia. Method: A national cross-sectional survey was conducted using a structured questionnaire assessing demographic profiles, workload, radiation protection practices, and health outcomes. Associations between variables were analyzed using appropriate statistical tests. Result: A total of 150 neurointerventionists participated in this study. Most were male (76%) and aged 40-49 years (48%). Nearly half performed <2 procedures weekly (48.7%), while 67.3% spent <5 hours in the catheterization laboratory. Although protective equipment use was common, only 34.7% consistently wore dosimeters, and 19.3% routinely monitored radiation exposure. Musculoskeletal pain was reported by 35.3% of participants, while fatigue and sleep disturbance affected 68.7% and 32.7% of participants, respectively. Musculoskeletal pain was significantly associated with fatigue, sleep disturbance, shorter sleep duration, and higher on-call workload, whereas regular exercise showed a protective effect (all p < 0.05). Longer catheterization laboratory duration was also associated with fatigue and sleep disturbance (p = 0.033 and p = 0.048, respectively). Conclusion: Neurointerventionists in Indonesia face significant occupational health challenges. Targeted strategies, such as workload management, improved radiation monitoring, and institutional support, are required.  

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