Key clinical point: Percutaneous patent foramen ovale (PFO) closure with the Amplatzer PFO Occluder significantly reduced migraine days and attacks in patients with episodic migraine who had PFO and were refractory to preventive medical therapy.
Major finding: At 12 months, PFO closure vs. medical therapy group showed a significantly greater mean reduction in monthly migraine days (−3.1 vs. −1.9 days; P = .02) and the number of monthly migraine attacks (−2.0 vs. −1.4; P = .01). Rate of complete migraine cessation was significantly higher in PFO closure vs. medical therapy (9% vs. 0.7%; P less than .001) group. No clinically relevant adverse events were reported.
Study details : Findings are from individual patient-level data from 2 randomized migraine trials PRIMA and PREMIUM involving 337 patients with episodic migraine and PFO randomly allocated to either PFO closure+medical therapy (n=176) or medical therapy alone (n=161).
Disclosures: The study did not receive any funding. Dr. AC Charles, Dr. S Sorensen, Dr. SD Silberstein and Dr. JM Tobis were on the steering committee for the PREMIUM trial. Dr. HP Mattle and Dr. B Meier were on the steering committee for the PRIMA trial. Dr. B West, Dr. B Meier and Dr. JM Tobis declared receiving funds, serving as proctor/speaker/consultant for various sources. All other authors declared no conflicts of interest.
Source: Mojadidi MK et al. J Am Coll Cardiol. 2021 Feb 16. doi: 10.1016/j.jacc.2020.11.068 .