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Migraine and percutaneous patent foramen ovale closure: a systematic review and meta-analysis

Yu-Jie Shi1, Jun Lv2, Xing-Ting Han3

  • 1Department of Neurology, Xi'an Jiaotong University, Xi'an, China.

BMC Cardiovascular Disorders
|July 28, 2017
PubMed
Abstract

Insights

Patent foramen ovale (PFO) closure significantly improves migraine with aura (MA). Benefits are less certain for migraine without aura (MwoA), suggesting aura presence guides PFO closure decisions.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Devices

Background:

  • Established association between patent foramen ovale (PFO) and migraine with aura (MA).
  • Uncertainty regarding PFO closure benefits for migraine without aura (MwoA).

Purpose of the Study:

  • To systematically evaluate the efficacy of PFO closure in patients experiencing migraine.
  • To compare the outcomes of PFO closure for migraine with aura versus migraine without aura.

Main Methods:

  • Systematic literature search of Pubmed (January 2000 - July 2015).
  • Inclusion of eight clinical studies comprising 546 patients.
  • Primary endpoint: elimination or significant improvement of migraine symptoms post-PFO closure.

Main Results:

  • Significant migraine improvement in 81% of MA cases versus 63% of MwoA cases after PFO closure.
  • Summary odds ratio of 2.5 (95% CI 1.09-5.73) for migraine improvement.
  • PFO closure benefits were significantly greater in MA patients compared to MwoA patients (P=0.03).

Conclusions:

  • The presence of aura is a key factor in selecting migraine patients for PFO closure.
  • PFO closure demonstrates greater efficacy in patients with migraine with aura.
  • Aura presence serves as a clinical reference standard for PFO closure interventions in migraine patients.
Keywords:
MigraineMigraine with auraPatent foramen ovalePercutaneous patent foramen ovale closureRight-to-left shunt

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