TY - JOUR
T1 - Systematic review and meta-analysis of currently available clinical evidence on migraine and patent foramen ovale percutaneous closure
T2 - Much ado about nothing?
AU - Butera, Gianfranco
AU - Biondi-Zoccai, Giuseppe G L
AU - Carminati, Mario
AU - Caputi, Luigi
AU - Usai, Susanna
AU - Bussone, Gennaro
AU - Meola, Giovanni
AU - Delogu, Angelica Bibiana
AU - Sheiban, Imad
AU - Sangiorgi, Giuseppe
PY - 2010/3/1
Y1 - 2010/3/1
N2 - Objectives: To investigate the role of transcatheter closure of patent foramen ovale on the occurrence of migraine. Background: In recent years, a potential relationship between, migraine, stroke, and patent foramen ovale (PFO) has emerged. Methods: BioMedCentral, Google Scholar, and PubMed from January 2000 to December 2008 were systematically searched for pertinent clinical studies. Secondary sources were also used. Secondary prevention studies of transcatheter closure for patent foramen ovale were required to include at least more than 10 patients followed for more than 6 months. The primary end-point was the rate of cured or significantly improved migraine after percutaneous PFO closure. Results: After excluding 637 citations, we finally included a total of 11 studies for a total of 1,306 patients. Forty percent of the subjects included suffered from migraine, while most had a previous history of transient ischemic attack/stroke and were investigated retrospectively. Quantitative synthesis showed that complete cure of migraine in 46% (95% C.I.25-67%), while resolution or significant improvement of migraine occurred in 83% (95% C.I. 78-88%) of cases. Conclusions: Notwithstanding the limitations inherent in the primary studies, this systematic review suggests that a significant group of subjects with migraine, in particular if treated after a neurological event, may benefit from percutaneous closure of their patent foramen ovale. However, many questions remain unsolved.
AB - Objectives: To investigate the role of transcatheter closure of patent foramen ovale on the occurrence of migraine. Background: In recent years, a potential relationship between, migraine, stroke, and patent foramen ovale (PFO) has emerged. Methods: BioMedCentral, Google Scholar, and PubMed from January 2000 to December 2008 were systematically searched for pertinent clinical studies. Secondary sources were also used. Secondary prevention studies of transcatheter closure for patent foramen ovale were required to include at least more than 10 patients followed for more than 6 months. The primary end-point was the rate of cured or significantly improved migraine after percutaneous PFO closure. Results: After excluding 637 citations, we finally included a total of 11 studies for a total of 1,306 patients. Forty percent of the subjects included suffered from migraine, while most had a previous history of transient ischemic attack/stroke and were investigated retrospectively. Quantitative synthesis showed that complete cure of migraine in 46% (95% C.I.25-67%), while resolution or significant improvement of migraine occurred in 83% (95% C.I. 78-88%) of cases. Conclusions: Notwithstanding the limitations inherent in the primary studies, this systematic review suggests that a significant group of subjects with migraine, in particular if treated after a neurological event, may benefit from percutaneous closure of their patent foramen ovale. However, many questions remain unsolved.
KW - Meta-analysis
KW - Migraine
KW - Patent foramen ovale
KW - Stroke
KW - Transcatheter closure
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U2 - 10.1002/ccd.22232
DO - 10.1002/ccd.22232
M3 - Article
C2 - 20088014
AN - SCOPUS:77950527418
VL - 75
SP - 494
EP - 504
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
SN - 1522-1946
IS - 4
ER -