TY - JOUR
T1 - Improvement of Migraine After Patent Foramen Ovale Percutaneous Closure in Patients With Subclinical Brain Lesions. A Case-Control Study
AU - Vigna, Carlo
AU - Marchese, Nicola
AU - Inchingolo, Vincenzo
AU - Giannatempo, Giuseppe Maria
AU - Pacilli, Michele Antonio
AU - Di Viesti, Pietro
AU - Impagliatelli, Matteo
AU - Natali, Rosaria
AU - Russo, Aldo
AU - Fanelli, Raffaele
AU - Loperfido, Francesco
PY - 2009/2
Y1 - 2009/2
N2 - Objectives: We sought to evaluate the benefits on frequency and severity of migraine recurrence after patent foramen ovale (PFO) closure in patients with subclinical brain lesions at magnetic resonance imaging (MRI). Background: Migraine improvement has been reported after PFO closure in patients with cerebrovascular symptomatic events. Subclinical brain MRI lesions are detectable in patients with PFO and in migraineurs. Methods: A total of 82 patients with moderate/severe migraine, PFO, large right-to-left shunt, and subclinical brain MRI lesions were prospectively examined for a 6-month period. Patients were subdivided into closure (n = 53) and control (n = 29) group according to their consent to undergo percutaneous PFO closure. In controls, therapy for migraine was optimized. Six-month frequency and severity of migraine recurrence were compared with baseline. Results: The number of total attacks decreased more in the closure group (32 ± 9 to 7 ± 7, p <0.001) than in the control group (36 ± 13 to 30 ± 21, p = NS) (p <0.001). A significant reduction in disabling attacks was observed only in the closure group (20 ± 12 to 2 ± 2, p <0.001; controls: 15 ± 12 to 12 ± 12, p = NS). Migraine disappeared in 34% of the closure group patients and 7% of controls (p = 0.007); >50% reduction of attacks was reported by 87% and 21%, respectively (p <0.001). Disabling attacks disappeared in 53% of closure group patients and 7% of controls (p <0.001); >50% reduction occurred in 89% and 17%, respectively (p <0.001). Conclusions: In migraineurs with a large PFO and subclinical brain MRI lesions, a significant reduction in frequency and severity of migraine recurrence can be obtained by PFO closure when compared with frequency and severity in controls.
AB - Objectives: We sought to evaluate the benefits on frequency and severity of migraine recurrence after patent foramen ovale (PFO) closure in patients with subclinical brain lesions at magnetic resonance imaging (MRI). Background: Migraine improvement has been reported after PFO closure in patients with cerebrovascular symptomatic events. Subclinical brain MRI lesions are detectable in patients with PFO and in migraineurs. Methods: A total of 82 patients with moderate/severe migraine, PFO, large right-to-left shunt, and subclinical brain MRI lesions were prospectively examined for a 6-month period. Patients were subdivided into closure (n = 53) and control (n = 29) group according to their consent to undergo percutaneous PFO closure. In controls, therapy for migraine was optimized. Six-month frequency and severity of migraine recurrence were compared with baseline. Results: The number of total attacks decreased more in the closure group (32 ± 9 to 7 ± 7, p <0.001) than in the control group (36 ± 13 to 30 ± 21, p = NS) (p <0.001). A significant reduction in disabling attacks was observed only in the closure group (20 ± 12 to 2 ± 2, p <0.001; controls: 15 ± 12 to 12 ± 12, p = NS). Migraine disappeared in 34% of the closure group patients and 7% of controls (p = 0.007); >50% reduction of attacks was reported by 87% and 21%, respectively (p <0.001). Disabling attacks disappeared in 53% of closure group patients and 7% of controls (p <0.001); >50% reduction occurred in 89% and 17%, respectively (p <0.001). Conclusions: In migraineurs with a large PFO and subclinical brain MRI lesions, a significant reduction in frequency and severity of migraine recurrence can be obtained by PFO closure when compared with frequency and severity in controls.
KW - migraine
KW - patent foramen ovale closure
KW - subclinical brain lesions
UR - http://www.scopus.com/inward/record.url?scp=59149102351&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=59149102351&partnerID=8YFLogxK
U2 - 10.1016/j.jcin.2008.10.011
DO - 10.1016/j.jcin.2008.10.011
M3 - Article
C2 - 19463410
AN - SCOPUS:59149102351
VL - 2
SP - 107
EP - 113
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
SN - 1936-8798
IS - 2
ER -