ReviewFrontiers in neurology2025
Right-to-left shunt and transcranial Doppler as a diagnostic tool: when and how to run it. Position statement by the Italian society of neurosonology and cerebral haemodynamics.
Review in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Patent Foramen Ovale: Epidemiology, Risk Factors, Pathophysiology, Clinical Features, Diagnosis, and Management.MedComm · 2026Review
- Agitated Saline Contrast Echocardiography in the diagnosis of right to left shunts: Guidance and recommendations from the British Society of Echocardiography.Echo research and practice · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patent foramen ovale (PFO) represents a frequent congenital cardiac anomaly and the most common cause of right-to-left shunt (RLS), with relevant clinical implications in cryptogenic ischemic stroke among young adults. Accurate and standardized diagnostic strategies are essential to identify clinically significant shunts and guide therapeutic decisions, particularly regarding PFO closure. Under the auspices of the Italian Society of Neurosonology and Cerebral Haemodynamics (SINSEC), this position statement provides evidence-based recommendations on the diagnostic use of contrast-enhanced transcranial Doppler (c-TCD) for RLS detection. A structured literature review was conducted according to PRISMA 2020 methodology to ensure methodological transparency and rigor. The search covered PubMed, Scopus, and Web of Science databases for studies published between January 1990 and February 2025, using predefined keywords related to RLS, PFO, c-TCD, diagnostic accuracy, and procedural protocols. Eligible studies were screened and critically appraised to synthesize current evidence on diagnostic applications, methodological variability, and clinical utility of c-TCD. Subsequently, a Delphi consensus process was undertaken among representatives from 11 neurosonology centers with recognized expertise in cerebrovascular diagnostics. Three iterative rounds were conducted to reach agreement on key aspects of the c-TCD protocol, including patient preparation, contrast agent administration, monitoring settings, and shunt grading criteria. Draft recommendations were developed, revised collectively, and approved through a final plenary consensus meeting. The resulting position statement defines a standardized protocol for the execution, interpretation, and reporting of c-TCD in RLS diagnosis. Adoption of these consensus-based recommendations aims to enhance diagnostic accuracy, improve inter-center consistency, and support the broader clinical and research integration of c-TCD in cerebrovascular diagnostics.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.