The Journal of Vascular and Interventional Neurology (JVIN)
JVIN publishes reports of clinical and basic investigation of any aspect of the cerebral and spinal circulation and its diseases from many disciplines, including anesthesiology, critical care medicine, epidemiology, internal medicine, neurology, neuro-ophthalmology, neuropathology, neuropsychology, neurosurgery, nuclear medicine, nursing, radiology, rehabilitation, speech pathology, vascular physiology, and vascular surgery.
| Authors: | Ossama Mansour, Karim Gaber |
| Affiliation: | Alexandria University, Stroke and Neurointervention Center, Egypt |
| Section: | Illustrative Teaching Cases |
| Issue: | Vol. 16 No. 2 (2025): June |
| Published: | September 27, 2025 |
Background: Cavernous dural arteriovenous fistulas (CCFs) are rare vascular malformations that can lead to significant morbidity. This case illustrates a successful intervention for a patient with bilateral CCFs.
Case Presentation: A 50-year-old male presented with a progressive headache over four months, accompanied by left proptosis and chemosis for one week. Clinical evaluation revealed a classic triad of symptoms: proptosis, chemosis, and orbital bruit, without neurological deficits.
Conclusion: This case highlights the effectiveness of unilateral transvenous embolization in managing bilateral CCFs. Endovascular treatment remains the gold standard for symptomatic patients and offers a minimally invasive option with favorable outcomes.
Keywords: Cavernous dural arteriovenous fistula, embolization, transvenous approach, endovascular treatment ]]>
| Authors: | Ossama Mansour, Tamer Hassan, Nada Nasr, Salma Said, Ahmed Ossama, Syed I. Hussain, Maher Saqqur, Atilla Ozcan Ozdemir, Ozlem Aykac, Seby John, Nadia Hammami, Hosam Al-Jehani, Farid Aladham, Yahia Imam, Mostafa Mahmoud, Farouk Hassan, Mohamed Alaa Habib, Abdulrahman Alshamy, Mohamed Ghorbani, Faisal Alghamdi, Mohammed Wasay, Khaled Sobh, Amr Mahmoud, Ibrahim ALNAAMI, Achmad Fidaus Sani, Fritz Sumantri Usman, Anchlee Chourojana, Ehab S Mohamed, Amina El Khamlichi, Erdem Gurkas, Mehdi Farhodi, Ehsan Sharifipour, Ahmad Sobri MUDA, Hany hamadani, Mohamed Hamdy, Amal Al Hashmi, Umair Rashid, Mohamed Khaled Elwia, Hany Zaki eldeen, Ashfaq Shuaib |
| Section: | Original Research Article |
| Issue: | Vol. 16 No. 2 (2025): June |
| Published: | September 4, 2025 |
Background: Aneurysmal subarachnoid hemorrhage (aSAH) management across the diverse healthcare landscapes of the Middle East and North Africa (MENA) region requires evidence-based guidelines adapted to varying resource levels. The MENA Stroke and Interventional Neurotherapies Organization (MENA-SINO) developed these guidelines to address critical regional challenges while maintaining core principles of care.
Methods: Evidence was adapted from multiple international guidelines (AHA/ASA, ESO, NICE, Neurocritical Care Society, Chinese guidelines) using a systematic approach including comprehensive evidence review, multidisciplinary expert panel input, regional implementation barrier assessment, and formal consensus procedures.
Conclusion: These guidelines provide a resource-stratified framework for aSAH management across the MENA region, with practical adaptations that address the realities of diverse healthcare settings while preserving essential care components.
]]>| Authors: | Mohan Karki, Girish Rajpal |
| Affiliation: | Max Superspeciality Hospital |
| Section: | Original Research Article |
| Issue: | Vol. 16 No. 1 (2025): March |
| Published: | April 24, 2025 |
Objective: Carotid artery stenting is presently universally adopted for treatment of carotid artery stenosis. The objective of this study was to analyze the outcomes of carotid artery stenting (CAS) performed in a single institution.
Materials and Method: A retrospective study of 150 cases from January 2015 to January 2024. All patients were symptomatic, including 66 cases with distal embolic protection device (DEPD) and 84 cases without.
Results: There were 99 males and 51 females with mean age of 64.2 (range 20–81) years. Maximum incidence was noted in age group 50–70 years (62%). No mortality and no re-stenosis were reported at mean follow-up of 11.2 ± 6.7 months.
Conclusions: Carotid artery stenting for severe stenosis is found to be safe and successful. However, appropriate precaution should be given to patients who have ulcerated plaque.
]]>| Authors: | Ossama Mansour, Tamer Hassan, Nada Nasr, Salma Said, Syed I. Hussain, Maher Saqqur, Atilla Ozcan Ozdemir, Ozlem Aykac, Seby John, Nadia Hammami, Hosam Maher Al-Jehani, Farid Aladham, Yahia Imam, Mostafa Mahmoud, Farouk Hassan, Mohamed Alaa Habib, Abdulrahman Alshamy, Mohamed Ghorbani, Faisal Alghamdi, Mohammed Wasay, Ehab S Mohamed, Anchlee Chourojana, Achmad Fidaus Sani, Fritz Sumantri Usman, Ibrahim ALNAAMI, Amr Mahmoud, Khalid Sobh, Mahmoud Galal, Amina El Khamlichi, Erdem Gurkas, wael khalifa, Amal Al Hashmi, Mehdi Farhodi, abdelmoneom said, Hany Elhamadani, Mohamed Hamdy, Hany Zaki eldeen, Mohamed Khaled Elwia, Ahmad Sobri MUDA, Umair Rashid, Ashfaq Shuaib |
| Section: | Original Research Article |
| Issue: | Vol. 16 No. 1 (2025): March |
| Published: | April 22, 2024 |
Evidence-based guidelines tailored to the Middle East and North Africa (MENA) region are critical for improving stroke and neurointerventional outcomes, given varied epidemiological profiles, resource disparities, and cultural factors. This manuscript outlines a comprehensive framework established by the Middle East North Africa Stroke and Interventional Neurotherapies Organization (MENA-SINO) to develop, adapt, and update guidelines. The framework incorporates recognized methodologies (e.g., GRADE), encourages multidisciplinary collaboration, and addresses region-specific needs through "Resource-Limited" tags and novel Expert Opinion (EO) processes.
]]>| Authors: | Ossama Mansour, Farid Aladham, Ibrahim ALNAAMI, Hosam Al-Jehani, Abdulrahman Alshamy, Faisal Alghamdi, Atilla Ozcan Ozdemir, Tamer Hassan, Hany Zaki eldeen, Mohamed Alaa Habib, Nadia Hammami, Farouk Hassan, Syed I. Hussain, Yahia Imam, Seby John, Adnan Qureshi, Amina El Khamlichi, Ahmed Ossama, Umair Rashid, Maher Saqqur, Khalid Sobh, Ashfaq Shuaib |
| Section: | Original Research Article |
| Issue: | Vol. 16 No. 2 (2025): June |
| Published: | August 25, 2015 |
Background and Objectives: Neurointerventional laboratory standards vary significantly worldwide, lacking comprehensive evidence-based certification frameworks. We developed and validated a novel 6P Protocol (People, Place, Products, Protocols, Performance, Protection) encompassing 33 evidence-based standards for neurointerventional laboratory certification.
Methods: Developed through a modified Delphi process involving 15 international experts with external validation by 7 independent experts. Systematic evidence review of 33 subsections using 142 high-quality studies. Evidence classified using GRADE methodology.
Results: Of 33 subsections, 14 (42.4%) received Grade A evidence, 12 (36.4%) Grade B, and 7 (21.2%) Grade C. Protection domain showed highest Grade A evidence proportion (66.7%), followed by Protocols (50.0%).
Conclusions: The 6P Protocol demonstrates robust scientific grounding, with over three-quarters of subsections supported by moderate-to-high quality evidence. This provides the first comprehensive evidence-based framework for neurointerventional laboratory certification.
Keywords: Neurointerventional procedures, laboratory certification, 6P Protocol framework, evidence-based medicine, GRADE methodology, systematic review, stroke care, angiography laboratory standards ]]>