Upfront TEVAR plus medical therapy vs lifelong monitoring for uncomplicated type B aortic dissection
Official title: 1/2 IMPRoving Outcomes in Vascular DisEase - Aortic Dissection (IMPROVE-AD)
Funded at Duke University · NIH-11393329 · Data updated 2026-11-12
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.
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 | 2026 |
| Award (this year) | $1,862,156 |
| NIH project number | 5UH3HL165017-04 |
| Project ID | NIH-11393329 on NIH RePORTER |
Who could benefit from this research
✓Could help
Adults with uncomplicated type B aortic dissection who are candidates for either medical therapy with surveillance or upfront TEVAR.
✕Less likely to help
Patients with complicated dissection, contraindications to TEVAR, or those not eligible for trial participation may not benefit from the findings.
What this research studies
This project will enroll about 1,100 patients with uncomplicated type B aortic dissection across participating centers to compare two treatment approaches. One group will receive medical therapy plus upfront thoracic endovascular aortic repair (TEVAR), while the other group will be managed with medical therapy and surveillance for deterioration. The trial is designed to be pragmatic and straightforward, focusing on real-world applicability and outcomes during the initial hospitalization and follow-up period. A Clinical Coordination Center and a Statistical Data Coordinating Center will lead data collection, management, and analysis, with a diverse steering committee including patient advocates to guide the study. The goal is to provide clear guidance on whether early TEVAR improves survival and clinical outcomes compared with traditional surveillance in this patient population.
Why it matters
Potential benefit: If successful, the study could change guidelines and help patients with uncomplicated type B aortic dissection receive faster, evidence-based treatment decisions that may improve survival and avoid unnecessary procedures.
How similar studies have gone: Prior smaller studies have informed current management, but this trial is the first large-scale effort to definitively compare upfront TEVAR with surveillance in uTBAD.
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.
-
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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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.
-
Early aortic stent plus medicine versus medicine with watchful waiting for uncomplicated type B aortic dissection
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.
-
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.