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.

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,

SUBMITTER: Miceli G 

PROVIDER: S-EPMC12728742 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature