Systematic review and meta-analysis of currently available clinical evidence on migraine and patent foramen ovale percutaneous closure: Much ado about nothing?

Gianfranco Butera, Giuseppe G L Biondi-Zoccai, Mario Carminati, Luigi Caputi, Susanna Usai, Gennaro Bussone, Giovanni Meola, Angelica Bibiana Delogu, Imad Sheiban, Giuseppe Sangiorgi

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)494-504
Number of pages11
JournalCatheterization and Cardiovascular Interventions
Volume75
Issue number4
DOIs
Publication statusPublished - Mar 1 2010

Keywords

  • Meta-analysis
  • Migraine
  • Patent foramen ovale
  • Stroke
  • Transcatheter closure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

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