Patent Foramen Ovale Clinical Trial
Official title:
Precutaneous High Risk Patent Foramen Ovale to Treat Migraine Headaches:A Prospective,Multicenter,Randomized,Controlled Trial
The foramen ovale, a kind of physiologic channel in the interatrial septum in the heart at
embryonic stage, is closed normally at 5-7 months after birth. When it is not closed, it is
referred to as the patent foramen ovale (PFO), which is found in approximately 1/4 of general
population. It was shown in the studies in recent years that the risks of cryptogenic stroke,
migraine, peripheral arterial embolism and decompression sickness in the patients with PFO
were several times higher than those in healthy people. Therefore, PFO, previously considered
a condition without the necessity of treatment, causes the attention of many experts and
scholars around the world. Migraine with or without aura is defined as one of the most
disabling chronic diseases, since according to WHO, the disability adjusted life year caused
by migraine was second only to that by non-fatal stroke in 2005. In recent years, an
increasing number of researches suggested that migraine is closely related to the
right-to-left shunt (RLS) in the heart. And PFO is clinically considered as the most common
cause of RLS.
The closure treatment for PFO-induced migraine has been gradually applied in several
hospitals in China. The relationship of PFO with migraine, however, was not evaluated
systematically based on specific standards, unfortunately leading to non-inclusion of many
high-risk patients with PFO in the evaluation. The following aspects are to be fully
recognized: the selecting and screening procedures for the high-risk population with
PFO-induced migraine; the indications and standards of closure treatment for PFO in the
patients with PFO-induced migraine; and the possibility that the made-in-China occluders
substitute for those imported in the prevention from migraine. Furthermore, there is still a
lack of prospective, multi-center, randomized and controlled studies in this subject, and
standard or normal screening and treatment procedures have not yet been established in China.
From this point, the investigators developed the Chinese people-specific procedures and
standards of diagnosis of PFO-induced migraine in this study, based on current standards and
methods of diagnosis, treatment and prevention of PFO-induced migraine in foreign countries.
And the investigators prospectively adopted continuous inclusion of the high-risk patients
with PFO-induced migraine, who were randomly divided into the closure treatment
(transcatheter closure of PFO) group and the medication (drugs administered alone) group at
the ratio of 1:1., in order to evaluate if the interventional treatment is better than the
medication alone in these patients, to assess the efficacy and safety of the made-in-China
occluders in the interventional treatment and prevention of PFO-induced migraine, and to
identify the incidence of PFO in the patients with migraine in China and develop the Chinese
people-specific screening protocols of PFO-induced migraine.
n/a
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