Closure of Patent Foramen Ovale for Migraine Relief: A Study Headache

The final results from the MIST trial are disappointing.

Migraine with aura is more prevalent in individuals with a patent foramen ovale (PFO) than in the general population. Reports of resolved or improved migraine in retrospective studies of percutaneous-device closure of PFO for stroke provided the rationale for this prospective, randomized trial. The study was funded by the device manufacturer, which also had a substantial role in its design and oversight.

Included were 147 patients with ≥5 migraine headache days per month who had failed treatment with at least two classes of preventive medication and who had a moderate to large right-to-left shunt due to a PFO. They were randomized to percutaneous closure with implantation of a STARFlex septal repair device or to a sham procedure under genera…

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

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)