Objective:To evaluate the feasibility of interventional closure in migraine patients with moderate right -to -left shunt patent foramen ovale(RLS-PFO)by comparing the surgical difficulty and short-term efficacy between patients with moderate or large RLS-PFO. Methods:A total of 95 patients with migraine accompanied by moderate or large RLS-PFO who underwent interventional closure were selected. The differences inmigraine symptoms,closure success rate,closure difficulty,postoperative RLS volume and postoperative headache relief level were analyzed. Results:There was no significant difference in preoperative headache impact test-6 (HIT-6)and migraine disability assessment questionnaire(MIDAS)scores between the two groups(P>0.05). There was no difference in closure success rate between the two groups(92.00% vs. 98.57%,P=0.137),but the usage rate of the second guidewire,intracardiac ultrasound utilization rate,and X-ray exposure time were significantly higher in the moderate RLS-PFO group than in the large RLS- PFO group(P < 0.01). The effective closure rate at 3 days after the procedure was higher in the moderate RLS-PFO group than in the large RLS-PFO group(86.96% vs. 56.52%,P=0.008),but there were no differences in RLS volume and effective closure rate at 1 month,3 months and 6 months after operation between the two groups(P>0.05). The HIT-6 and MIDAS scores were improved at 6 months after the procedure compared to before the procedure in both groups(P<0.001),but the decrease in HIT-6 score at 6 months after the procedure was smaller in the moderate RLS-PFO group than in the large RLS-PFO group(P=0.012),while there was no difference in MIDAS score. Conclusion:The surgical difficulty of interventional closure in migraine patients with moderate RLS-PFO is higher than in patients with large RLS-PFO,but the efficacy of headache relief after interventional closure is similar between the two groups.