Percutaneous closure of patent foramen ovale for migraine headaches refractory to medical treatment

Abstract

These results suggest that percutaneous PFO closure durably alters the spontaneous course of shunt associated migraine.

Primary Transcatheter Patent Foramen Ovale Closure Is Effective in Improving Migraine in Patients With High-Risk Anatomic and Functional Characteristics for Paradoxical Embolism

“…We observed, in contrast to other studies (25)(26)(27)(28)(29)(30)(31), total eradication of aura in all patients with pre-procedural aura. One purely speculative explanation might be that aura itself is related to certain anatomic and functional characteristics of the right atrium including large R-L shunt, ASA, and EV, independent of any association with migraine.…”

Improvement of migraine headaches after percutaneous closure of patent foramen ovale for secondary prevention of paradoxical embolism

“…In 17 patients with migraine headaches refractory to medical treatment undergoing percutaneous PFO closure solely for attempted treatment of their headaches, we recently reported30 similar results, with complete cessation of headaches in 24% of patients, persisting but improved headaches in 47% and unchanged headaches in 29%. Overall, the prevalence of any migraine headaches decreased from 100% to 76% ( p =ns), and the prevalence of migraine with aura from 82% to 24% ( p =0.002).…”

Patent Foramen Ovale May Be Causal for the First Stroke but Unrelated to Subsequent Ischemic Events

“…We followed 308 consecutive patients for a mean period of 8.7 years, which was substantially longer than has been the follow-up of previous studies. [1][2][3][4] Several case-control studies implicated PFO as a potential cause of stroke, presumably because of paradoxical embolism. 1,10 This observational evidence and the continuous improvement of catheter-driven closure devices has led to widespread use of percutaneous device closure of the PFO.…”

“…There are only a few large studies reporting midterm results after percutaneous PFO closure. [2][3][4] Given that competing stroke etiologies are likely to emerge or to be newly diagnosed with advancing age, longer follow-up duration may shed more light on the causal link between PFO and recurrent ischemic events. For instance, a PFO that had been responsible for the initial stroke may prove unrelated to subsequent events if a diagnostic reinvestigation identifies a more likely cause of stroke.…”