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Transcatheter closure of patent foramen ovale (PFO) for prevention of recurrent cryptogenic cerebrovascular events (CVE) has not been officially approved in Japan. However, previous studies suggested that >10000 patients/year are suffered from a cryptogenic stroke due to PFO in Japan. Additionally, several studies revealed the improvement for a migraine after PFO closure.
Since 2007, we have performed transcatheter closure of PFO in 34 patients. Mean age at procedure was 45 years, including 26 patients with stroke, 3 with TIA, 4 with a migraine and 1 with brain abscess. A presence of interatrial right-to-left shunts was demonstrated by transesophageal contrast echocardiography in all. PFO closure was performed using Amplatzer Septal Occluder (n=15), Amplatzer Cribriform device (n=5) or Amplatzer PFO Occluder (n=14).
All procedures were successfully performed. During the follow-up period (40 ± 11 months), no device-related complications were observed. Recurrent TIA attack without of evidence of MRI stroke finding was observed in 1. In 11 of 15 patients complicated with a migraine before, complete resolution or significant reduction was observed.
Although our data could not demonstrate the therapeutic advantages compare to anticoagulation, this procedure should be considered as one of the medical options for patients with CVE or a migraine.