关键词: 卵圆孔未闭, 偏头痛, 右向左分流, 封堵术

Abstract: Objective To evaluate the efficacy and related factors of patent foramen ovale(PFO) occlusion in patients with migraine.Methods From January 2017 to December 2019,116 migraineurs with PFO successfully underwent transcatheter PFO closure in our hospital.Patients completed a migraine burden questionnaire at baseline and at 6 and 12 months of follow-up after the PFO closure.Migraine severity is reported as Headache Impact Test-6(HIT-6) scores and migraine frequency(days/month).The relevant clinical characteristics of the patients were also collected.Results Of 116 patients,a total of 107 patients obtained data for analysis except for 9 cases that were lost to follow-up.One year after PFO closure,migraine was significantly relieved in 53 cases(50%) and effectively relieved in 85 cases(79%).There was significant difference in HIT-6 score before and 1 year after PFO closure(64.36 vs.49.99,P<0.01),and the number of headache days per month was significantly lower than that before PFO closure(6.88 vs.2.46,P<0.01).Clinical multivariate logistic regression analysis showed that the HIT-6 score and duration of headache before occlusion were correlated with headache relief(both P<0.05).The mean HIT-6 score of patients with no residual shunt and small residual shunt after occlusion was significantly lower than that of patients with moderate-large residual shunt(48.41 ± 9.014 vs.55.18 ± 8.658,P<0.05).Conclusions PFO closure in migraine patients with PFO can effectively alleviate headache.Severe preoperative headache and short course of disease are independent predictors of headache relief.The moderate-large residual shunts affect the effectiveness of percutaneous Closure on Migraineurs with PFO.

Key words: Patent Foramen Ovale, Migraine, Right-to-left Shunt, Occlusion