Observation Of The Curative Effect Of Interventional Closure Of Foramen Ovale In Patients With Migraine

Objective: This study retrospectively analyzed the headache relief of patent oval foramen(PFO)patients complicated with different types of migraines after PFO interventional occlusion,to explore the clinical efficacy and surgical safety of PFO interventional occlusion for different types of migraines.Methods: A total of 150 patients diagnosed as Right-to-left shunt(RLS)with Pfos combined with different types of migraine were followed up from September 2020 to September 2022 in the neurology department of Affiliated Hospital of Jining Medical College.The patients were treated with PFO interventional occlusion after admission.Immediately after the operation,the Contrast transthoracic echocardio graphy(c-TTE)was improved to clarify the occlusion and shunt status.Ecg,echocardiography and c-TTE results were observed 24 h,1 month,3months,and 6 months after surgery to monitor postoperative complications.Headache impact Test-6(HIT-6)was conducted to evaluate the level of headache before and after surgery,and the effective rate of headache treatment after PFO interventional occlusion was analyzed.Statistical analysis was carried out.Results: A total of 150 patients with large RLS shunt and Pfos with different types of migraine were included in this study,including 60males(40.0%)and 90 females(60.0%),ranging in age from 14 to 63 years with a mean age of(44.45±13.28)years.There were 123 cases of Migraine without aura(MO)(82.0%),15 cases of Migraine with aura(MA)(10.0%),and Chronic migraine(Chronic migraine,CM)in 12patients(8.0%).All patients successfully completed PFO interventional occlusion,2 patients showed precardiac discomfort after surgery,1patient showed anxiety,mental tension and other non-organic lesions,and their symptoms improved after treatment,and the remaining patients showed no discomfort during the operation and within 24 hours after surgery.Cardiac color ultrasound and c-TTE were evaluated after surgery.No surgery-related complications were found in all patients.The shunt was in good position and no obvious shunt occurred again,indicating that the operation was safe.Compared with pre-operation,the HIT-6 scores of all patients decreased significantly at 1 month,3 months and 6 months after surgery,and the difference was statistically significant(P<0.05).The HIT-6 scores of patients with different subtypes also decreased at 1month,3 months and 6 months after surgery,and the difference was statistically significant(P<0.05).The pairwise comparison of migraine without aura(MO),migraine with aura(MA)and migraine with chronic(CM)showed no statistical significance(P>0.05).Conclusion: 1.This study showed that PFO interventional occlusion in the treatment of a large number of RLS shunt patients with migraine had a certain degree of symptom improvement,and the effective rate of surgery was independent of the subtype of migraine.