关键词: 卵圆孔未闭, 卵圆孔封堵术, 儿童

Abstract:

Objective The correlation between patent foramen ovale (PFO) and unexplained migraine in children has attracted increasing attention, yet evidence regarding transcatheter PFO closure in pediatric populations remains limited. This retrospective cohort study aimed to investigate the association between occluder type (biodegradable occluder versus metallic occluder) and migraine relief, and to evaluate the clinical efficacy and safety of transcatheter PFO closure in children with migraine combined with PFO. Methods A total of 62 pediatric patients aged 6-18 years who underwent transcatheter PFO closure for recurrent migraine from January 2023 to June 2025 were retrospectively enrolled. Patients were divided into a biodegradable occluder group (biodegradable group, 12 cases) and a metallic occluder group (metallic group, 50 cases) according to the implanted occluder type, with the follow-up deadline set as December 2025. The primary outcome measure was the migraine relief rate at 6 months postoperatively, defined as a reduction in the Headache Impact Test-6 (HIT-6) score to less than 50 points. The secondary outcome measure was the incidence of adverse cardiovascular events. Intergroup comparisons were performed. Results No statistically significant intergroup differences were observed in baseline characteristics including gender, age, body weight, and preoperative migraine severity (all P>0.05). At 6 months after surgery, the overall migraine relief rate reached 83.9% (52/62), with rates of 86.0% (43/50) in the metallic group and 75.0% (9/12) in the biodegradable group. Taking the metallic group as the reference, the relative risk (RR) of migraine relief in the biodegradable group was 0.87 (95% confidence interval CI: 0.61-1.25), showing no statistically significant difference between groups (P>0.05). HIT-6 scores were significantly decreased in both groups compared with preoperative levels (P<0.05). No moderate-to-large residual shunts, occluder displacement, arrhythmias or other adverse cardiovascular events occurred in either group during follow-up, and the incidence of adverse events did not differ significantly between the two groups (P>0.05). Conclusion Transcatheter PFO closure is safe and effective for pediatric migraine patients refractory to medical therapy with confirmed right-to-left shunt. Biodegradable occluders demonstrate comparable short-term efficacy and safety to conventional metallic occluders. Given their biodegradable property, biodegradable occluders can serve as a preferred option for pediatric patients.

Key words: patent foramen ovale closure, bioabsorbable occluder, child