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. 2020 Sep;16(3):315-320.
doi: 10.5114/aic.2020.99267. Epub 2020 Oct 2.

Impact of percutaneous patent foramen ovale closure on migraine headaches in patients with history of ischemic neurological events

Węglarz Przemysław  1 , Katarzyna Spisak-Borowska  2 , Tomasz Bochenek  3 , Ewa Konarska-Kuszewska  3 , Jerzy Machowski  2 , Maria Trusz-Gluza  3 , Grzegorz Bajor  1 , Katarzyna Mizia-Stec  3 , Joel P Giblett  4 , Patrick A Calvert  4
Affiliations

Impact of percutaneous patent foramen ovale closure on migraine headaches in patients with history of ischemic neurological events

Węglarz Przemysław et al. Postepy Kardiol Interwencyjnej. 2020 Sep.

Abstract

Introduction: Observational studies have shown that migraine has been associated with patent foramen ovale (PFO). Whilst studies investigating PFO closure for the treatment of migraine have been neutral, there is some evidence that symptoms of migraine may improve if the PFO was closed after ischemic stroke.

Aim: To establish whether closure of PFO in patients with stroke or transient ischemic attack (TIA) is associated with reduction in the severity of co-existent migraine headaches.

Material and methods: Patients with ischemic stroke or TIA, PFO suitable for percutaneous closure and migraine, were given migraine severity questionnaires prior to PFO closure. These were followed up at 6 and 12 months after closure with the same questionnaire. The primary endpoint was change in migraine severity using the Migraine Severity Scale (MIGSEV). Migraine episode frequency, disability (using the MIDAS scale), and pain intensity were also assessed.

Results: Sixty-two patients were included in the analysis. MIGSEV scores reduced from 7 (7-8) at baseline to 4 (3.25-6) at 6-month follow-up, and 3 (0-4) at 12-month follow-up (p < 0.001). Other measures of migraine headache were also improved at both 6- and 12-month follow-up. Twenty-four (38%) patients were rendered migraine free at 12 months.

Conclusions: PFO closure for stroke or TIA prevention in patients with migraine was associated with a reduction in markers of migraine headache severity.

Keywords: headache; migraine; patent foramen ovale; patent foramen ovale closure; stroke.

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Conflict of interest statement

Dr Calvert undertakes proctoring for Abbott Vascular and Occlutech. Other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart
Figure 2
Figure 2
Primary and secondary endpoints at baseline, 6- and 12-month follow-up. All changes are significant (p < 0.01) on Friedman test for change over multiple timepoints
See this image and copyright information in PMC

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