• Daniela Trabattoni, Franco Fabbiocchi, Piero Montorsi, Stefano Galli, Giovanni Teruzzi, Luca Grancini, Pamela Gatto, and Antonio L Bartorelli.
• Centro Cardiologico Monzino, Department of Cardiovascular Sciences, University of Milan, Milan, Italy. daniela.trabattoni@ccfm.it
• Catheter Cardiovasc Interv. 2011 Mar 1; 77 (4): 570-4.

ObjectivesThis single-center, observational, prospective study evaluated the impact of patent foramen ovale (PFO) closure on migraine attacks over time.BackgroundPFO closure may reduce the frequency and severity of migraine headaches in patients with significant right-to-left shunts.MethodsBetween May 2000 and September 2009, 305 consecutive patients (mean age, 43 ± 12 years; 54.5% women) with a prior embolic cerebrovascular event underwent PFO closure with the Amplatzer PFO occluder for recurrence prevention. All patients had right-to-left shunts; the shunts were associated with migraine symptoms in 77 (25%), either alone (n = 64, 83%) or with aura (n = 13, 17%). Septal aneurysm was present in 15 (19.5%) migraine patients, and 43 (56%) had a previous transient brain ischemic attack. All migraine patients had a computed tomography scan or magnetic resonance imaging, indicating a previous brain ischemic lesion. All 305 patients underwent transthoracic echocardiography with clinical follow-up at 24 hr, at 3, 6, and 12 months, and then yearly.ResultsAn acute migraine attack occurred 24-48 hr after PFO closure in 28 (36.4%) of 77 patients. There was a significant reduction (>50%) in the number and intensity of attacks in 46 (60.5%) of 77 patients at the 3-month follow-up. At the 12-month follow-up, migraine had ceased in 23 (46%) patients, and 20 (40%) had a reduction in the migraine recurrence rate and disabling symptoms. These results were maintained at follow-up (mean, 28 ± 27 months). There was overall improvement in migraine in 89% of the treated patients.ConclusionsPercutaneous PFO closure in migraineurs may provide beneficial mid-term and long-term results, with significant reduction in the intensity and frequency of headache symptoms.Copyright © 2010 Wiley-Liss, Inc.

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