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Transcatheter closure of patent foramen ovale: a new migraine treatment? J Interv Cardiol. Percutaneous closure of patent foramen ovale reduces the frequency of migraine attacks. Association of interatrial shunts and migraine headaches: impact of transcatheter closure. High prevalence of patent foramen ovale in migraine with aura.
The influence of percutaneous atrial septal defect closure on the occurrence of migraine. Eur Heart J. Migraine headache relief after transcatheter closure of patent foramen ovale. Long-term efficacy of transcatheter patent foramen ovale closure on migraine headache with aura and recurrent stroke. Transcatheter patent foramen ovale closure mitigates aura migraine headaches abolishing spontaneous right-to-left shunting.
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A single-centre study. J Cardiovasc Med. Usefulness of transcatheter patent foramen ovale closure in migraineurs with moderate to large right-to-left shunt and instrumental evidence of cerebrovascular damage.
Percutaneous closure of patent foramen ovale for migraine headaches refractory to medical treatment. Transcatheter patent foramen ovale closure is effective in reducing migraine independently from specific interatrial septum anatomy and closure devices design.
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Support Center Support Center. External link. Please review our privacy policy. Wilmshurst et al. Morandi et al. Schwerzmann et al. Reisman et al. Azarbal et al. Ferrarini et al. Mortelmans et al. Giardini et al. Dubiel et al.
Jesurum et al. Luermans et al. Chessa et al. Wahl et al. Papa et al. Rigatelli et al. Trabattoni et al. Araszkiewicz et al. Supraventricular arrhythmias 3, groin hematoma 3, neurological events 5. Some authors agree that migraine with aura and PFO have higher coincidences than would be expected by chance and that it is possible that both conditions are inherited together.
Objective: The present review aims to make a comprehensive attempt at clarifying the PFO-migraine connection in light of recent evidence from literature. Evidence acquisition: A Medline search using both OVID and PubMed was performed by searching for literature in English regarding randomized trials, prospective cohort studies, meta-analyses, reviews and editorials about PFO and migraine between and While this procedure is relatively noninvasive and typically successful in the sense of achieving anatomical closure, to date we lack suffi- cient proof to justify performing PFO closure for migraine prevention except in the setting of welldesigned and carefully supervised clinical research studies.
To repeat: until these or other studies can demonstrate clear evidence of safety and benefit associated with PFO closure for migraine, that procedure cannot be considered a viable part of the therapeutic arsenal used for migraine prevention. Click here to read about our editorial board members. Skip to content. In fact, an association triggers showed negative RLS. Along with stroke, however, migraine and particularly b Among MA patients and considering the presence of MA have been the focus of greater interest in studies on PFO.
The elevated frequency Among patients in our study that many patients had RLS classified as mas- without these triggers there was a lack of massive RLS sive, i. This finding has also been triggers and with massive RLS, for a prevalence of reported with very similar figures in both transoe- massive shunt of Nevertheless, the numeric association does not imply causality.
According to most authors, the other basic reason for defending the causal role of PFO in migraine is the Discussion improvement in migraine after foramen ovale closure. Many authors suggest that the association between PFO is a vestige of foetal circulation that results from PFO and migraine is incidental and linked to hereditary a failure of the septum primum and secundum to fuse and factors, with no direct link.
Since the initial comments of has been reported [28]. Nevertheless, the results only indi- and in fact the presence of septal defects appears to be cate a trend and the absence of a correlation would not transmitted in a dominant autonomic manner and signifi- invalidate the initial hypothesis, as it is known that patients cantly associated with MA [29], without this MA—PFO with PFO experience shunt without pulmonary hyperten- association being significantly linked to the female sex sion, both at rest and during activities as common as [30].
These findings sustain, in part, the hypothesis of a coughing [39—41]. We should again mention the high num- genetically determined association which would include a ber of patients in our study who presented significant shunt subgroup of MA associated to PFO, although no author at rest. In contrast to this theory, the preliminary results of has demonstrated a mechanism that could relate them. During data collec- description of this scenario [32].
The migraine triggers tion patients were included consecutively without consid- could be microembolisations from the venous territory ering any characteristics, except for MA according to the [12] or, more likely, some activated molecule or particle current diagnostic criteria. The control subjects were that may elude the filtering or deactivation ability of the selected to match such characteristics as mean age and lung parenchyma.
This role of the lungs in migraine as a sex, and there were no significant differences in medical filter is not new in the literature [33]. The candidate sub- history between the two groups. However, in order to min- stance according to these authors would be the amines, in imise type two error and confounding results, the control particular 5-hydroxytryptamine 5-HT , which is implicat- group should be increased and should be at least as large ed in the genesis of migraine [34] and probably a platelet as the MA group.
Another systematic error that cannot be hyperactivation state already shown in the pathogenesis of ruled out in this design is recall bias when reporting trig- the migraine [35]. To complete this hypothesis the capaci- gers, although triggers were routinely collected in the ty of the pulmonary vessels to inactivate 5-HT has also medical interview prior to ultrasonographic study and reported [36].
The series that report improvements in determination of RLS, in order to minimise this bias. Whether or not the bypass resulting from PFO the routine 0. In our hyperexcitability affected by other triggers is a matter of opinion this correction is too conservative when testing speculation. According to this scenario, patients with PFO hypotheses using variables that are mutually correlated. In and migraine may recognise that daily life situations that this case-control, exploratory study this correction with induce Valsalva manoeuvres do trigger crises by increasing correlated variables might have increased the chance that the extent of RLS.
This hypothesis has already been men- true associations would not be discovered. Our results supports the PFO—migraine connection, but this associa- would support the role of RLS as a trigger in at least some tion remains, on the whole, unexplained. We consider it to patients, due to the mechanisms mentioned. In addition, be of maximum interest to answer a variety of questions: this statement would be true for both MA where the asso- Is it an aetiological or accidental relation?
What is the ciation is particularly prevalent for reasons not yet under- exact mechanism? References 1. Anzola GP Clinical impact of 2.
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