Clinical Efficacy Of Transcatheter Closure Of Patent Foramen Ovale With Positive Foaming Test

Objectives:To explore and evaluate the clinical therapeutic effect of interventional occlusion in the treatment of Patent Foramen Ovale(PFO)with positive foaming test in the prevention and treatment of Cryptogenic Stroke(CS)and to provide clinical basis for individualized treatment of CS patients with PFO.Methods:A total of 151 patients who were admitted to Nanchong Central Hospital from January 2019 to December 2021 were divided into two groups:drugs therapy group(n=63)and interventional occlusion+drugs therapy group(n=88).The general clinical data of the patients were collected by retrospective study,including sex,age,body weight,Right to Left Shunt(RLS)magnitude,the degree of migraine before treatment,and telephone follow-up of all patients after treatment.Results:There was no significant difference in general clinical data,including sex,age and body weight between the two groups(P>0.05).In the interventional occlusion+drugs treatment group,the stroke recurrence rate within 6 month after operation was significantly lower than that in the drugs treatment group,and the difference was statistically significant(P<0.05);In the interventional occlusion+drugs treatment group,the degree of migraine was lower than that in the drugs treatment group at the 3rd month after operation,and the difference was statistically significant(P<0.01);the degree of migraine at the 6th month after operation was lower than that in the drugs treatment group,but the difference was not statistically significant(P>0.05).Combined with generalized analysis,that the risk of moderate or severe headache in the interventional occlusion+drugs group decreased by 40%(OR=0.60,P<0.05).In the interventional occlusion+drugs treatment group,the degree of migraine in female patients was significantly lower than that in male patients at the 3rd month after operation,and the difference was statistically significant(P<0.05);the degree of migraine in female patients was lower than that in male patients at the 6th month after operation,and the difference was statistically significant(P=0.01).Combined with generalized analysis,the risk of moderate or severe headache in female patients decreased by 55%(OR=0.45,P<0.05).There were significant differences between these three RLS grade patients for preoperative migraine,migraine at the 3rd month after operation and migraine at the 6th month after operation(P<0.01,P<0.01,P<0.05).Compared with the preoperative migraine and the migraine at the 3rd month after operation,patients with RLS grade 3 had a more obvious headache relief at the 6th month after operation than those with RLS grade 2.Conclusion:Compared with drugs therapy,interventional occlusion+drugs therapy can reduce the risk of CS recurrence,improve the prognosis and significantly reduce the degree of migraine.Patients of different genders had different degrees of migraine,women had a lighter degree of migraine and a reduced risk of moderate or severe headaches,women benefited more after treatment.Patients with different RLS grades had a different postoperative migraine relief.Patients with preoperative RLS grade 3 had a more obvious postoperative migraine relief,and patients with preoperative RLS grade 3 benefited more after treatment.