Early aortic stent plus medicine versus medicine with watchful waiting for uncomplicated type B aortic dissection
Official title: 1/2 IMPRoving Outcomes in Vascular DisEase - Aortic Dissection (IMPROVE-AD)
Funded at Duke University · NIH-11381649 · Data updated 2026-11-12
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 start | July 21, 2023 |
| Project end | June 30, 2030 |
| Funding year | 2025 |
| Award (this year) | $5,355 |
| NIH project number | 3UH3HL165017-03S2 |
| Project ID | NIH-11381649 on NIH RePORTER |
Who could benefit from this research
✓Could help
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.
✕Less likely to help
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.
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.
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 gone: 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
-
Duke University
Durham, United States Active
Researchers
- Principal investigator: Patel, Manesh R — Duke University
- Study coordinator: Patel, Manesh R
Related research
Other NIH-funded projects on the same topics.
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Improving Outcomes in Vascular Disease for Aortic Dissection: Upfront TEVAR vs Surveillance
A large US study will compare starting treatment with a repair procedure plus medicine to medicine alone with careful follow-up in people with uncomplicated type B aortic dissection.
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Improving Outcomes in Aortic Dissection: Upfront TEVAR vs Surveillance (IMPROVE-AD) for Uncomplicated Type B Dissection
A large, patient-friendly study will compare starting with medicine plus an upfront TEVAR procedure versus medicine with careful monitoring for people with uncomplicated type B aortic dissection.
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IMPROVE-AD: Better outcomes for uncomplicated type B aortic dissection
A large patient study in the US will compare starting with medical care plus upfront TEVAR versus medical care with monitoring alone to see which approach leads to better outcomes for people with uncomplicated type B aortic dissection.
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Upfront TEVAR plus medical therapy vs lifelong monitoring for uncomplicated type B aortic dissection
A large US study tests whether adding early TEVAR to standard medical care helps people with uncomplicated type B aortic dissection live better than medical care alone with ongoing monitoring.
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Non-invasive 4D flow MRI to predict risk in aortic dissection
A study using 4D flow MRI to help doctors predict which patients with aortic dissection are at higher long-term risk so they can tailor treatment.
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Improving care for people with type B aortic dissection
This study will compare immediate stent-graft repair plus medicines to medicines with watchful waiting for people with uncomplicated type B aortic dissection.
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.