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Patent Foramen Ovale Closure for Treating Migraine: A Meta-Analysis

Yu Zhang1,2, Haijiao Wang1, Ling Liu1

  • 1Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Lane 37, Chengdu 610041, Sichuan, China.

Journal of Interventional Cardiology
|February 21, 2022
PubMed
Abstract

Insights

Percutaneous patent foramen ovale (PFO) closure effectively reduces migraine frequency and monthly migraine days. This intervention is particularly efficient for resolving migraine headaches with aura.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Interventions

Background:

  • Observational studies suggest percutaneous patent foramen ovale (PFO) closure is safe for reducing migraine frequency and duration.
  • Migraine is a prevalent neurological condition often associated with a patent foramen ovale.

Purpose of the Study:

  • To evaluate the efficacy and safety of PFO closure in patients experiencing migraines.
  • To synthesize evidence from multiple study types to assess PFO closure outcomes for migraine treatment.

Main Methods:

  • A systematic literature search was conducted across Pubmed (MEDLINE), Embase, and Cochrane Library databases.
  • Included studies comprised randomized controlled trials (RCTs), cohort studies, and retrospective case series published between January 1, 2001, and February 30, 2021.
  • Literature quality was assessed using the Jadad scale, and meta-analysis was performed using R 4.1.0 software.

Main Results:

  • The meta-analysis included 1,165 participants from three RCTs, one pooled study, and eight retrospective case series.
  • PFO closure significantly reduced headache frequency (OR=1.5698, p=0.0293) and monthly migraine attacks/days (OR=0.2594, p=0.0048) compared to control.
  • Subgroup analysis indicated resolution of migraine headaches in patients with aura following PFO surgery (OR=1.5856, p=0.0227).

Conclusions:

  • Percutaneous PFO closure is an effective treatment for reducing headache frequency and monthly migraine days.
  • The procedure demonstrates particular efficiency in treating migraine attacks accompanied by aura.

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