Therapeutic effect of percutaneous closure of patent foramen ovale on migraine
Objective To observe the effect of percutaneous closure of patent foramen ovale(PFO)on migraine,and to explore its safety.Methods From January to December 2022,98 patients with PFO and migraine were diagnosed and treated in the Second Affiliated Hospital of Zhengzhou University,among whom 62 patients received percutaneous PFO closure(surgical treatment group),and 36 patients received medical treatment(conventional treatment group).Echocardiography was performed in surgical treatment group on the second day and 3 months after surgery to record the detachment and displacement of the occluder,embolism,hematoma,residual shunt,pericardial effusion,arrhythmia,heart failure and other complications.Headache impact test-6(HIT-6)score and visual analogue scale(VAS)score were compared between two groups before and after 6-month treatment.The changes of symptoms after 6-month treatment,and stroke,transient cerebral ischemia,myocardial infarction and syncope during follow-up were recorded.Results(1)The course of migraine was longer in surgical treatment group[730.0(52.5,3 650.0)d]than that in conventional treatment group[90.0(12.5,1 368.8)d](P＜0.05),and there were no significant differences in the male ratio,age,body mass index,and right-left shunt grade between two groups(P＞0.05).(2)The surgery was successful in all patients in surgical treatment group,with no complications such as embolism,hematoma,or detachment and displacement of the occluder.The postoperative stay was 1 to 2 d.In 3 months after surgery,no complications developed as occluder displacement and detachment,residual shunt,pericardial effusion,arrhythmia,or heart failure.(3)The HIT-6 score and VAS score showed no significant differences between surgical treatment group(62.47±3.74,7.74+1.20)and conventional treatment group(63.17±3.95,8.86±0.99)before treatment(P＞0.05),which were higher than those after 6-month treatment in two groups(HIT score:36.10±0.43,49.44±1.99;VAS:0,4.42±3.58)(P＜0.05),and were lower in surgical treatment group than those in conventional treatment group(P＜0.05).(4)Migraine disappeared completely in 53 patients and improved significantly in 9 patients 6 months after surgery in surgical treatment group,and disappeared completely in 11 patients,improved significantly in 4 patients and showed no change in conventional treatment group.The relief rate of migraine was higher in surgical treatment group(100.0％)than that in conventional treatment group(41.7％)(x2=77.000,P＜0.001).(5)The follow-up till June 2023 showed no stroke,transient cerebral ischemia,myocardial infarction or syncope in two groups.Conclusion Percutaneous PFO closure surgery can effectively relieve migraine symptoms with high security.
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