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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence
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Closure of a Patent Foramen Ovale (PFO): An Intervention Sequence

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Is patent foramen ovale closure effective in reducing migraine symptoms? A controlled study

Carey Kimmelstiel1, Christopher Gange, David Thaler

  • 1Cardiac Catheterization Laboratory, Division of Cardiology, Department of Medicine, Tufts-New England Medical Center, Boston, Massachusetts 02111, USA. ckimmelstiel@tufts-nemc.org

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|February 14, 2007
PubMed
Abstract

Insights

Patent foramen ovale (PFO) is linked to more frequent and severe migraines. PFO closure significantly reduces migraine frequency, severity, and medication use, improving quality of life.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Devices

Background:

  • A documented association exists between patent foramen ovale (PFO) and migraine headaches.
  • Emerging data suggest PFO closure may alleviate migraine symptoms, though many prior studies lacked control groups.
  • This study addresses the need for controlled investigations into PFO closure's efficacy for migraine management.

Purpose of the Study:

  • To determine the prevalence of migraine in patients with PFO.
  • To evaluate the impact of percutaneous PFO closure on migraine frequency, severity, and quality of life.
  • To assess changes in abortive medication usage following PFO closure.

Main Methods:

  • A controlled study involving three groups: No PFO (Controls, n=65), PFO without intervention (Open PFO, n=63), and PFO with percutaneous closure (Closed PFO, n=41).
  • Migraine frequency, severity, and impact (MIDAS scores) were assessed before and 90 days after intervention or sham procedure.
  • Comparisons included abortive medication use between baseline and follow-up.

Main Results:

  • Migraine, particularly with aura, was significantly more prevalent in both PFO groups compared to controls (P < 0.05).
  • The Closed PFO group experienced an 83% reduction in migraine frequency versus 0% in Open PFO and 10% in Controls (P < 0.0001).
  • PFO closure led to significant reductions in migraine severity (P < 0.0001) and MIDAS scores (P = 0.035), with 71% of patients reducing abortive medication use (P < 0.001).

Conclusions:

  • This controlled study confirms a higher prevalence of migraine, especially with aura, in individuals with PFO.
  • Percutaneous PFO closure effectively reduces migraine frequency and severity, leading to improved quality of life as indicated by MIDAS scores.
  • PFO closure is associated with a substantial decrease in the need for acute migraine medications.

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