Factors associated with residual shunt occurring after closure surgery of patent foramen ovale and its relationship with the relief degree of migraine
10.3969/j.issn.1008-794X.2025.01.005
- VernacularTitle:卵圆孔未闭封堵后残余分流发生的相关因素及与偏头痛缓解程度的关系
- Author:
Tianxu LI
1
;
Boyan JIAO
;
Xipeng YAN
Author Information
1. 273155 山东济宁 济宁学院校医院
- Keywords:
closure of patent foramen ovale;
residual shunt;
migraine;
relief degree
- From:
Journal of Interventional Radiology
2025;34(1):28-32
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the factors associated with residual shunt occurring after closure surgery of patent foramen ovale(PFO,and to analyze the relationship between the residual shunt and the relief degree of migraine.Methods A total of 210 patients with PFO,who received closure surgery of PFO due to the occurrence of premonitory migraine at the Jining Municipal First People's Hospital of China from January 2020 to December 2022,were collected.The clinical data,visual analogue scale(VAS)score,and headache impact test-6 questionnaire(HIT-6)score of patients having postoperative residual shunt and patients having no postoperative residual shunt were analyzed.Results A total of 172 patients had no postoperative residual shunt(no-shunt group),and 38 patients had postoperative residual shunt(shunt group).The preoperative PFO width in the shunt group was(1.72±0.34)mm,which was obviously larger than(1.42±0.31)mm in the no-shunt group(P＜0.05).The proportion of patients with right-to-left shunt grades Ⅰ-Ⅱ in resting state in the shunt group was 94.74％,which was higher than 65.21％in the no-shunt group(P＜0.05).No statistically significant differences in gender,age,body mass index(BMI),diabetes,hypertension,hyperlipemia,operation time and occluder type existed between the two groups(P＞0.05).Logistic regression analysis showed that preoperative PFO width and the grade of right-to-left shunt in resting state were the influencing factors for the occurrence of residual shunt(P＜0.05).Based on this model,a column chart model for predicting residual shunt was established,and its predicted area under the ROC curve was 0.882(95％CI:0.731-0.944),the sensitivity was 82.50％,and specificity was 81.00％.The postoperative 12-month VAS score and HIT-6 score in the shunt group were(1.87±0.29)points and(56.02±9.08)points respectively,which were remarkably higher than those in the no-shunt group(P＜0.05).The improvement rates of VAS score and HIT-6 score in the shunt group were(72.59±9.17)％and(22.43±8.11)％respectively,which was lower than those in the no-shunt group(P＜0.05).The postoperative 12-month VAS score and HIT-6 score in the patients having severe residual shunt were(2.21±0.41)points and(61.38±8.45)points respectively,which were higher than those in the patients having mild residual shunt(P＜0.05).The residual shunt volume was negatively correlated with the improvement rates of VAS score and HIT-6 score(r=-0.546 and r=-0.738 respectively,both P＜0.05).Conclusion Residual shunt volume is negatively associated with the relief degree of migraine in patients after receiving closure surgery of PFO due to the occurrence of premonitory migraine.
