The Observation Of The Clinical Curative Effect And Safety Of Percutaneous Closure Of Patent Foramen Ovale On23Migraineurs

PURPOSE： To Evaluate the clinical curative effect and safety ofpercutaneous closure of patent foramen ovale on migraineurs.MATERIALS AND METHODS：The materials that23patients who hadmigraine, contrast transcranial doppler (TCDc) positive and underwenttranscatheter patent foramen ovale closure in cadiovascular surgery, whichwere collected from the neurology department of Bethune First Hospital ofJilin University between2010May and2011November. A four-level RLScategorization based on the microbubble (MB) count was applied: level1:0MBs; level2:1-10MBs; level3:>10MBs and no curtain (Figure1.C); andlevel4: curtain. After a period of time, the patients were reexamined TCDc orTTE in order to observe whether exist residual shunt. Observe their headacheimprovement with HIT-6questionnaire, using a retrospective statisticalanalysis.RESULTS：Percutaneous closure was successful in all patients, withoutmajor persistent side-effects. All patients were received telephone follow-upafter the closure (48–542days, mean247±144.55days), the scores of HIT-6between38and70(mean51±8.55), compared with the preoperative scores(between42to76, mean61±8.12), the disability affected by migraine hadsignificantly improved (P <0.05).6patients were MA, after the closure,thescores of HIT-6(between46and56, mean51±3.14), compared with thepreoperative scores (between63to76, mean69±3.86), the disability affectedby migraine had significantly improved (P <0.05);17patients were MoA.after the closure, the scores of HIT-6(between36and70, mean52±9.73),compared with the preoperative scores (between42to69, mean60±7.70), the disability affected by migraine had significantly improved (P <0.05).18/23patients accepted MRI or CT examination before the operation,8patients hadneurological events (such as cerebral infarction, cerebral ischemia), averageage was44±6.88years old, the disability affected by magraine hadsignificantly improved (the HIT-6scores58±10.41to49±7.20, p <0.05);10patients were no neurological change, average age was25±8.3years old, thedisability affected by magraine also had significantly improved(the HIT-6scores62±6.72to52±10.44, p <0.05).4/23(17%) patients still had RLSshunt after the closure, there was no staistically significant of the HIT-6scoresbetween preoperative and postoperative(62±6.78to54±4.79，P=NS).4patients with residual shunt,2patients’ RLS descent from level3to level2,1patient’s descent from level4to level3, while1patient’s was still level3.CONCLUSION：The prevalence of PFO in patients with headache ishigher than those without headache. Compare with the younger migraineurswith PFO, the prevalence of nervous system event is higher than the older’s.Percutaneous closure of PFO has effect on the cure of migraine, and it is safe.The presence of residual shunt after percutaneous closure of PFO has effect onthe improvement of migraine symptom.