Patent Foramen Ovale Closure for Migraine Relief: A Persistent Headache

In a nonrandomized study, closure of PFO greatly improved migraine symptoms in patients at high risk for paradoxical embolism.

Data from small observational studies suggest that migraine headaches improve or resolve in selected patients who undergo closure of patent foramen ovale (PFO), usually for indications other than migraine. However, the only randomized trial to test this potential benefit of PFO closure did not confirm it (JW Cardiol Mar 26 2008).

Now, researchers have prospectively assessed the effects of PFO closure in 40 patients (85% women) who had refractory and disabling migraines (80% with aura) and who also were at high risk for paradoxical embolism. All patients had an atrial septal aneurysm, eustachian valve, large shunt, and coagulation abnormalities. None had previously experienced a cerebral embolism.

After a mean follow-up of 29 months, complete …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI