Early aortic stent plus medicine versus medicine with watchful waiting for uncomplicated type B aortic dissection
1/2 IMPRoving Outcomes in Vascular DisEase - Aortic Dissection (IMPROVE-AD)
This compares giving an early aortic stent graft plus medicines to using medicines with close follow-up for people with uncomplicated type B aortic dissection to find which approach leads to better outcomes.
Quick facts
| Grant type | NIH-funded research |
|---|---|
| Study type | NIH-funded research |
| Funding institution | Duke University NIH-funded |
| Lab location | 1 site (Durham, United States) |
| Project ID | NIH-11381649 on NIH RePORTER |
What this research studies
You would be randomly assigned to one of two approaches: medicines plus an upfront thoracic endovascular aortic repair (TEVAR) procedure, or medicines with regular monitoring and a procedure only if your condition worsens. The trial plans to enroll about 1,100 people across U.S. hospitals and follows participants during hospitalization and after discharge to track complications, procedures, and survival. Care teams will provide standard medical therapy and use usual clinical imaging and tests as needed, and any clinically indicated TEVAR or open repair during follow-up will be performed per routine care. The goal is to provide clear guidance on whether earlier repair improves long-term safety compared with watching closely.
Who could benefit from this research
Good fit: Adults diagnosed with uncomplicated type B aortic dissection who are stable enough for either medical therapy or endovascular repair and can attend follow-up visits.
Not a fit: People with complicated dissections (such as rupture or ongoing organ ischemia), those too frail for TEVAR, or those with other aortic conditions like ascending dissections are unlikely to benefit from this comparison.
Why it matters
Potential benefit: If successful, this could show whether adding early TEVAR to medical therapy reduces deaths, complications, or emergency surgeries for people with uncomplicated type B aortic dissection.
How similar studies have performed: Previous smaller trials and observational studies of TEVAR in type B dissection have shown mixed results, and this is the first large pragmatic U.S. trial designed to provide definitive guidance.
Where this research is happening
Durham, United States
- Duke University — Durham, United States (Active)
Researchers
- Principal investigator: Patel, Manesh R — Duke University
- Study coordinator: Patel, Manesh R
About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page below.