ABSTRACT
Objective:
This study aims to investigate the
therapeutic efficacy of
patent foramen ovale (PFO) closure in
migraine patients with a massive right-to-left shunt (RLS) and
white matter lesions (WMLs).
Methods:
The
research focused on
migraine patients with a massive RLS
who underwent PFO closure in our
hospital from June 2020 to June 2021. The study included 51
patients without WMLs (
control group, CG) and 27
patients with WMLs (
observation group, OG). A 12-month postoperative follow-up
survey was conducted to assess
headache episodes (frequency and duration), evaluated using the
Headache Impact Test-6 (HIT-6) and the
Pain Intensity Visual Analog Scale (VAS). The psychological
state was also evaluated using the Hamilton
Anxiety and
Depression Scale (HAMA, HAMD). Adverse reactions during the follow-up were recorded.
Results:
No significant differences in perioperative and prognostic adverse reactions were observed between OG and CG (P > .05). Both groups showed a reduction in postoperative
headache episodes and
pain intensity. However, the OG exhibited higher frequency and duration of
headache episodes and elevated HIT-6 and VAS scores, resulting in lower
clinical efficacy (P < .05). Postoperatively, both groups demonstrated reductions in HAMA and HAMD, with CG showing lower scores compared to OG (P < .05).
Logistic regression analysis identified the
course of the
disease, HIT-6 score, and the presence of WMLs as independent
risk factors for the
efficacy of PFO closure (P < .05).
Conclusions:
PFO closure proves effective and safe in treating
migraine patients with RLS. However, for those with WMLs, clinical
attention should be directed toward the
treatment of WMLs.