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Integrated Photoacoustic, Ultrasound, and Angiographic Tomography (PAUSAT) for NonInvasive Whole-Brain Imaging of Ischemic Stroke
06:45

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Published on: June 2, 2023

The ASCOD phenotyping of ischemic stroke (Updated ASCO Phenotyping)

P Amarenco, J Bogousslavsky, L R Caplan

    Cerebrovascular Diseases (Basel, Switzerland)
    |August 1, 2013
    PubMed

    Insights

    ASCOD is an updated phenotyping system for ischemic stroke, incorporating dissection and simplifying diagnostic criteria. This refined approach better captures underlying diseases in stroke patients, especially younger individuals.

    Area of Science:

    • Neurology
    • Vascular Neurology
    • Stroke Medicine

    Background:

    • ASCO phenotyping is used to describe underlying diseases in ischemic stroke patients.
    • The original ASCO system included atherosclerosis, small-vessel disease, cardiac pathology, and other causes.
    • Existing phenotyping systems may not fully capture all relevant etiologies, particularly in younger stroke populations.

    Purpose of the Study:

    • To introduce ASCOD, an enhanced phenotyping system for ischemic stroke.
    • To incorporate dissection as a distinct category and simplify diagnostic evidence levels.
    • To improve the characterization of underlying diseases in ischemic stroke patients.

    Main Methods:

    • The ASCO system was evolved into ASCOD by adding 'D' for dissection.
    • Diagnostic evidence levels were simplified and integrated into existing grades.
    • The cutoff for significant stenosis was lowered from 70% to 50%.
    • A specific pattern for cardiogenic stroke using neuroimaging was added.

    Main Results:

    • ASCOD recognizes dissection as a frequent cause, especially in young stroke patients.
    • The simplified system integrates diagnostic evidence into grades 0 and 9.
    • The revised stenosis cutoff (50%) aligns with common clinical practice.
    • ASCOD captures and weights the overlap between multiple underlying diseases.

    Conclusions:

    • ASCOD provides a more comprehensive phenotyping of ischemic stroke.
    • The updated system is particularly beneficial for young stroke patients with dissection.
    • ASCOD facilitates a more accurate understanding of stroke etiology by considering disease overlap.

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