Long-term impact of transcatheter closure interatrial shunts on disabling migraine.

Autor: Rigatelli G; Department of Cardiology, Ospedali Riuniti Padova Sud, Padova, Italy., Pasquetto G; Department of Cardiology, Cittadella General Hospital, Cittadella, Italy., Zuin M; Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
Jazyk: angličtina
Zdroj: Acta cardiologica [Acta Cardiol] 2024 Jul; Vol. 79 (5), pp. 575-581. Date of Electronic Publication: 2024 May 31.
DOI: 10.1080/00015385.2024.2356903
Abstrakt: Backgrounds: Effectiveness of patent foramen ovale (PFO) closure on relief of migraine, is still unclear. We sought to analyse the long-term (>10 years) effects of interatrial septal shunt repair on disabling migraine performing a retrospective non-randomised study.
Methods: Clinical records of patients with disabling, medication-refractory migraine and PFO or significant ASD referred to our centre for closure from 2006 to 2018, were analysed.
Results: Forty -six patients (38 female, mean age 40.0 ± 3.7 years) with PFO and 32 patients with significant ASD (28 female, mean age 38.0 ± 4.1 years) submitted to transcatheter closure had a pre-existing disabling migraine with mean Migraine Disability Assessment Score (MIDAS) of 35.8 ± 4.7. After a mean follow-up of 118.2 ± 19.1 months (range 96 to 144), 72 out of 78 patients were still followed-up: in all subjects, aura was abolished, and migraine improved also in patients without aura. The mean MIDAS significantly decreased from baseline value ( p  < 0.01). Complete migraine resolution was associated in PFO patients with a shorter history of migraine, a more severe thrombophilic profile, a more severe Right-to-Left Shunt (RLS) and larger left atrial diameter and volume, and in ASD patients with bidirectional shunt.
Conclusions: Device-based repair of PFO/ASD in patients with migraine was associated with abolition of aura and symptoms reduction in the long-term period.
Databáze: MEDLINE