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2 patent foramen ovale PFO PFO 1990 PFO PFO Amplatzer PFO

3 CQ 1 50 B patent foramen ovale PFO migraine with aura MA PFO migraine without aura MO 20 2,444 PFO 2016 MA MO MA PFO 50 MA PFO 2008 Schwedt PFO OR OR CI PFO MA 54.8 MO 30.0 p ,101 PFO 14.6 vs 15MA MO 19 vs PFO PFO 5, 6 CQ 1 3

4 1 Tariq N, Tepper SJ, Kriegler JS : Patent foramen ovale and migraine : closing the debate A review. Headache 2016 ; 56 3 : Schwedt TJ, Demaerschalk BM, Dodick DW : Patent foramen ovale and migraine : a quantitative systematic review. Cephalalgia 2008 ; 28 5 : Iwasaki A, Suzuki K, Takekawa H, Takashima R, Suzuki A, Suzuki S, Hirata K : Prevalence of right to left shunts in Japanese patients with migraine : a single center study. Intern Med 2017 ; : Rundek T, Elkind MS, Di Tullio MR, Carrera E, Jin Z, Sacco RL, Homma S : Patent foramen ovale and migraine : a cross sectional study from the Northern Manhattan Study NOMAS. Circulation 2008 ; : Anzola GP, Morandi E, Casilli F, Onorato E : Different degrees of right to left shunting predict migraine and stroke : data from 420 patients. Neurology 2006 ; 66 5 : Schwerzmann M, Nedeltchev K, Lagger F, Mattle HP, Windecker S, Meier B, Seiler C : Prevalence and size of directly detected patent foramen ovale in migraine with aura. Neurology 2005 ; 65 9 : DB Pubmed 2016/2/6 Migraine patent foramen ovale 465 4

5 CQ 2 OR CI B CQ1 patent foramen ovale PFO PFO migraine with aura MA 14 2,602 PFO MA Schwedt PFO OR OR CI PFO MA OR CI OR 1 Tariq N, Tepper SJ, Kriegler JS : Patent foramen ovale and migraine : closing the debate A review. Headache 2016 ; 56 3 : Schwedt TJ, Demaerschalk BM, Dodick DW : Patent foramen ovale and migraine : a quantitative systematic review. Cephalalgia 2008 ; 28 5 : CQ 2 5

6 DB Pubmed 2016/2/6 Migraine patent foramen ovale 465 6

7 CQ 3 B patent foramen ovale PFO migraine with aura MA PFO PFO 20 1,194 PFO PFO PFO 19 Amplatzer RCT PFO 1 MIST 2 PFO MA STARFlex 74 sham P 0.51 CQ 3 7

8 2 PRIMA MA Amplatzer PFO P P PREMIUM Amplatzer PFO 107 sham /3 MA P P RCT PFO 1 Tariq N, Tepper SJ, Kriegler JS : Patent foramen ovale and migraine : closing the debate A review. Headache 2016 ; 56 3 : Takaya Y, Akagi T, Kijima Y, Nakagawa K, Kono S, Deguchi K, Sano S, Ito H : Influence of transcatheter closure of atrial communication on migraine headache in patients with ischemic stroke. Cardiovasc Interv Ther Dowson A, Mullen MJ, Peatfield R, Muir K, Khan AA, Wells C, Lipscombe SL, Rees T, De Giovanni JV, Morrison WL, Hildick Smith D, Elrington G, Hillis WS, Malik IS, Rickards A : Migraine Intervention With STARFlex Technology MIST trial : a prospective, multicenter, double blind, sham controlled trial to evaluate the effectiveness of patent foramen ovale closure with STARFlex septal repair implant to resolve refractory migraine headache. Circulation 2008 ; : Mattle HP, Evers S, Hildick Smith D, Becker WJ, Baumgartner H, Chataway J, Gawel M, Göbel H, Heinze A, Horlick E, Malik I, Ray S, Zermansky A, Findling O, Windecker S, Meier B : Percutaneous closure of patent foramen ovale in migraine with aura, a randomized controlled trial. Eur Heart J 2016 ; : Charles A, Silberstein S, Sorensen S, Maini B, Horwitz P, Gurley J, Tobis J. Results of the PREMIUM trial : patent foramen ovale closure with the AMPLATZER TM PFO occlude for the prevention of migraine. Headache 2015 ; 55 S5 : 251. DB Pubmed 2016/2/6 Migraine patent foramen ovale closure 250 8

9 CQ 4 A patent foramen ovale PFO 2016 PFO Amplatzer PFO FDA PFO MIST STARFlex Amplatzer PFO FDA Dowson A, Mullen MJ, Peatfield R, Muir K, Khan AA, Wells C, Lipscombe SL, Rees T, De Giovanni JV, Morrison WL, Hildick Smith D, Elrington G, Hillis WS, Malik IS, Rickards A : Migraine Intervention With STARFlex Technology MIST trial: a prospective, multicenter, double blind, sham controlled trial to evaluate the effectiveness of patent foramen ovale closure with STARFlex septal repair implant to resolve refractory migraine headache. Circulation 2008 ; : MedicalDevicesAdvisoryCommittee/CirculatorySystemDevicesPanel/UCM pdf#search=%27amplatzer+PFO+occlu der%27 CQ 4 9

10 DB Pubmed 2016/2/6 1. patent foramen ovale clsore adverse events Amplatzer PFO occlude adverse events 21 10

11 CQ B patent foramen ovale PFO PFO atrial septal defect ASD 10 2, 3 PFO ASD 2, ASD 171 CANOA vs PFO RCT 2 CANOA 4, 5 2, 3 CQ 5 11

12 1 Tariq N, Tepper SJ, Kriegler JS. Patent foramen ovale and migraine : closing the debate A review. Headache 2016 ; 56 3 : Kato Y, Kobayashi T, Ishido H, Hayashi T, Furuya D, Tanahashi N : Migraine attacks after transcatheter closure of atrial septal defect. Cephalalgia 2013 ; : Rodés Cabau J, Horlick E, Ibrahim R, Cheema AN, Labinaz M, Nadeem N, Osten M, Côté M, Marsal JR, Rivest D, Marrero A, Houde C : Effect of Clopidogrel and Aspirin vs Aspirin Alone on Migraine Headaches After Transcatheter Atrial Septal Defect Closure : The CANOA Randomized Clinical Trial. JAMA 2015 ; : Dowson A, Mullen MJ, Peatfield R, Muir K, Khan AA, Wells C, Lipscombe SL, Rees T, De Giovanni JV, Morrison WL, Hildick Smith D, Elrington G, Hillis WS, Malik IS, Rickards A : Migraine Intervention With STARFlex Technology MIST trial : a prospective, multicenter, double blind, sham controlled trial to evaluate the effectiveness of patent foramen ovale closure with STARFlex septal repair implant to resolve refractory migraine headache. Circulation 2008 ; : Charles A, Silberstein S, Sorensen S, Maini B, Horwitz P, Gurley J, Tobis J : Results of the PREMIUM trial: patent foramen ovale closure with the AMPLATZER TM PFO occlude for the prevention of migraine. Headache 2015 ; 55 S5 : 251. DB Pubmed 2016/2/6 1. patent foramen ovale clsore clopidogrel atrial septal defect clopidogrel 11 12

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