Impact of Patent Foramen Ovale Closure on the Frequency of Migraine: Waikato Hospital Experience

Abstract

Introduction: The association of patent foramen ovale (PFO) and migraine remains unclear. Aim: To determine the long-term effect of percutaneous closure of patent foramen ovale (PFO) defects on the incidence and frequency of migraine. Methods: This was a retrospective telephone survey in consecutive patients who underwent percutaneous PFO closure at Waikato hospital. The frequency of migraine before and after PFO closure was noted. Results: 53 procedures were done on 50 patients. Indication for PFO closure was stroke (94%), peripheral embolisation (2%), barotrauma (2%) and post operative desaturation (2%). 56% patients were male and average age was 46 years. 98% of patients had a successful PFO closure with 6% closed at the second attempt and 1(2%) closed surgically. In 1patient PFO was purposefully left unclosed. Bubble study at 6 months was done in 92% of patients. In 87% of patients complete closure were observed. There was no device migration, erosion or thrombus noted. At the follow-up period of 1337 ± 785days, 47 patients had telephone interview. 14 (30%) patients had an incidental history of migraine before the PFO closure. 50% reported a complete resolution of migraine with 1 new onset migraine post PFO closure. 87% reported a reduction of migraine episodes per week after PFO closure (p = 0.04). Conclusion: Closure of PFO shows a strong association with reduction in migraine frequency.Tabled 1Before PFO closureAfter PFO closurePMigraine n (%)14 (30%)8 (17%)0.22Average Migraine episodes per week4560.04 Open table in a new tab