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Therefore, an updated ischemic stroke classification system is needed to integrate these advancements, enabling a more targeted workup and potentially improving treatment strategies. We propose a more comprehensive but practical and generalizable diagnostic evaluation and checklist for patients with ischemic stroke to help identify definite, probable, or possible mechanisms related to cardioembolism, large artery atherosclerosis, small vessel disease, or other determined causes (eg, hypercoagulable disorders, genetic disorders, cancer, or dissection). This expands the minimum diagnostic evaluation, leading to reclassification of patients and possibly improving secondary stroke prevention strategies. This will also create a new framework for targeted treatments and randomized trials for various ischemic stroke subtypes.<\/jats:p>","DOI":"10.1161\/strokeaha.125.051169","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T05:00:10Z","timestamp":1761109210000},"page":"3552-3562","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Proposal for the Ischemic Stroke Phenotyping System 2025: ISPS25"],"prefix":"10.1161","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0031-1004","authenticated-orcid":true,"given":"Shadi","family":"Yaghi","sequence":"first","affiliation":[{"name":"Department of Neurology, Brown University, Providence, RI (S.Y., F.K., K.L.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0393-3589","authenticated-orcid":true,"given":"Michelle 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