Percutaneous Closure of Patent Foramen Ovale under TEE Guidance in
Cryptogenic Stroke and Migraine
Background. To investigate safety and clinical efficacy of percutaneous
closure of PFO under TEE guidance in patients with cryptogenic stroke
(CS) and migraine, combined PFO and large right-to-left shunt（RLS）.
Methods. From January 2018 to June 2021 in our hospital, 128 patients
were treated by percutaneous PFO occlusion under TEE guidance in CS and
migraine. Effective occlusion rate, complications, cerebral ischemia
events, migraine relief, and hospitalization costs were analyzed.
Postoperative follow-up were conducted. Results. All the 128 patients
were successful in percutaneous PFO occlusion. The average operation
time was 20~32 (25.6±4.2) min, the average
hospitalization time was 2~3(2.8±0.4) d. There were 122
patients without RLS and 6 patients with medium residual RLS, with the
sealing efficiency of 95.31% by TTE and right heart contrast
echocardiography. 30 patients with migraine underwent percutaneous PFO
occlusion, 24 patients relief after operation, with a relief rate of
80.0%. Postoperative follow-up was conducted for
1-36（28.8±3.6）months, and no follow-up was lost. 98 cases of CS with
PFO underwent percutaneous blockade were followed up without cerebral
embolism recurrence, 26 of 30 patients with migraine received
significant remission of migraine, with remission rate of 86.66%. There
were no serious adverse events. Conclusions. For patients with CS and
migraine, combined PFO and large RLS, percutaneous PFO occlusion under
the guidance of TEE has fewer complications and is safe and effective.
It can prevent the recurrence of CS and treat migraine.