IMPRoving Outcomes in Vascular DisEase - Aortic Dissection

NCT ID: NCT06087029

Last Updated: 2025-09-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

1100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-14

Study Completion Date

2030-06-30

Brief Summary

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The goal of this clinical trial is to determine whether an upfront invasive strategy of TEVAR plus medical therapy reduces the occurrence of a composite endpoint of all-cause death or major aortic complications compared to an upfront conservative strategy of medical therapy with surveillance for deterioration in patients with uncomplicated type B aortic dissection.

Detailed Description

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The study will be a prospective, pragmatic, randomized clinical trial of the comparative effectiveness of an initial strategy for the treatment of uncomplicated type B aortic dissection (uTBAD). Patients with uTBAD and no prior history of aortic intervention will be randomized within 48 hours to 6 weeks after index admission to one of the two initial strategies. Follow-up will be ascertained via a centralized call center and ascertainment of medical records, as well as remote blood pressure monitoring. Recommendations regarding medical therapy will be made to enrolling centers and feedback on the quality of medical care given, however, all subsequent care, with the exception of aortic interventions, will be at the discretion of the responsible clinical care team. Aortic interventions will allowable only as per protocol.

Conditions

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Type B Aortic Dissection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Upfront TEVAR plus Medical Therapy

Participants randomized to upfront TEVAR will receive a commercially available device customized to their individual anatomical requirements. Stent-graft implantation will be performed either in the operating room with appropriate digital imaging equipment to allow fluoroscopic and trans-esophageal echo (TEE) guidance or the catheterization laboratory, angiographic suite (with digital angiographic equipment).

Group Type EXPERIMENTAL

TEVAR

Intervention Type PROCEDURE

Thoracic endovascular aortic repair

Guideline directed medical therapy and surveillance of dissection

Intervention Type OTHER

Routine clinical care with suggested antihypertensive therapy and cardiovascular risk factor reduction as per appropriate cardiovascular guidelines.

Medical Therapy with surveillance for deterioration

Participants randomized to upfront Medical Therapy with Surveillance for Deterioration will be treated per routine clinical care with suggested antihypertensive therapy and cardiovascular risk factor reduction as per appropriate cardiovascular guidelines.

Group Type ACTIVE_COMPARATOR

Guideline directed medical therapy and surveillance of dissection

Intervention Type OTHER

Routine clinical care with suggested antihypertensive therapy and cardiovascular risk factor reduction as per appropriate cardiovascular guidelines.

Interventions

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TEVAR

Thoracic endovascular aortic repair

Intervention Type PROCEDURE

Guideline directed medical therapy and surveillance of dissection

Routine clinical care with suggested antihypertensive therapy and cardiovascular risk factor reduction as per appropriate cardiovascular guidelines.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Age \> 21 years
2. Patients with a Stanford type B aortic dissection not involving the aorta at or proximal to the innominate artery, without rupture and/or malperfusion syndrome (renal, mesenteric, or extremity) who are within 48 hours to 6 weeks after start of index admission for their type B dissection

4\. Ability to provide written informed consent 5. Investigator believes anatomy is suitable for TEVAR

Exclusion Criteria

1. Ongoing systemic infection
2. Pregnant or planning to become pregnant in the next 3 months
3. Life expectancy related to non-aortic conditions \< 2 years
4. Unwilling or unable to comply with all study procedures
5. Known patient history of genetic aortopathy
6. Penetrating Aortic Ulcer without concomitant uTBAD
7. Intramural hematoma without concomitant uTBAD
8. Iatrogenic (traumatic) aortic dissection
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The University of Texas Health Science Center, Houston

OTHER

Sponsor Role collaborator

State University of New York - Downstate Medical Center

OTHER

Sponsor Role collaborator

Oregon Health and Science University

OTHER

Sponsor Role collaborator

National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

Duke University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Manesh R Patel, M.D.

Role: PRINCIPAL_INVESTIGATOR

Duke University

Firas F Mussa, M.D.

Role: PRINCIPAL_INVESTIGATOR

The University of Texas at Houston

Panos Kougias, M.D.

Role: PRINCIPAL_INVESTIGATOR

The State University of New York at Downstate

Sreekanth Vemulapalli, M.D.

Role: PRINCIPAL_INVESTIGATOR

Duke University

Sean O'Brien, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

Duke University

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status RECRUITING

Honorhealth

Phoenix, Arizona, United States

Site Status RECRUITING

Memorial Care Long Beach Medical Center

Long Beach, California, United States

Site Status RECRUITING

Keck Medical Center of USC

Los Angeles, California, United States

Site Status RECRUITING

University of California San Diego

San Diego, California, United States

Site Status WITHDRAWN

University of California

San Francisco, California, United States

Site Status RECRUITING

Stanford University Medical Center

Stanford, California, United States

Site Status WITHDRAWN

University of Colorado Denver

Aurora, Colorado, United States

Site Status RECRUITING

Memorial Hospital Central

Colorado Springs, Colorado, United States

Site Status RECRUITING

Hartford Hospital

Hartford, Connecticut, United States

Site Status RECRUITING

Yale University

New Haven, Connecticut, United States

Site Status RECRUITING

University of Florida Health

Gainesville, Florida, United States

Site Status RECRUITING

Tampa General Hospital

Tampa, Florida, United States

Site Status RECRUITING

Northwestern University

Chicago, Illinois, United States

Site Status RECRUITING

The University of Chicago

Chicago, Illinois, United States

Site Status WITHDRAWN

Southern Illinois University School of Medicine

Springfield, Illinois, United States

Site Status RECRUITING

Indiana University Methodist Hospital

Indianapolis, Indiana, United States

Site Status RECRUITING

University of Kansas Medical Center

Kansas City, Kansas, United States

Site Status RECRUITING

MaineHealth

Scarborough, Maine, United States

Site Status RECRUITING

Johns Hopkins University

Baltimore, Maryland, United States

Site Status RECRUITING

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status RECRUITING

Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status RECRUITING

University of Massachusetts Memorial

Worcester, Massachusetts, United States

Site Status RECRUITING

University of Michigan Health

Ann Arbor, Michigan, United States

Site Status RECRUITING

Henry Ford Health System

Detroit, Michigan, United States

Site Status RECRUITING

Spectrum Health and Hospitals and Corewell

Grand Rapids, Michigan, United States

Site Status RECRUITING

University of Minnesota

Minneapolis, Minnesota, United States

Site Status RECRUITING

Mayo Clinic

Rochester, Minnesota, United States

Site Status WITHDRAWN

University of Missouri Health Care

Columbia, Missouri, United States

Site Status RECRUITING

Washington University School of Medicine

St Louis, Missouri, United States

Site Status WITHDRAWN

University of Nebraska Medical Center

Omaha, Nebraska, United States

Site Status WITHDRAWN

Cooper University Hospital

Camden, New Jersey, United States

Site Status RECRUITING

Rutgers UH Vascular Center

Newark, New Jersey, United States

Site Status RECRUITING

Maimonides Medical Center

Brooklyn, New York, United States

Site Status WITHDRAWN

Icahn School of Medicine at Mount Sinai

New York, New York, United States

Site Status RECRUITING

University of Rochester Medical Center

Rochester, New York, United States

Site Status RECRUITING

St. Francis Hospital and Heart Center

Roslyn, New York, United States

Site Status RECRUITING

Stony Brook University Medical Center

Stony Brook, New York, United States

Site Status RECRUITING

SUNY Upstate Medical University

Syracuse, New York, United States

Site Status RECRUITING

University of North Carolina Chapel Hill

Chapel Hill, North Carolina, United States

Site Status WITHDRAWN

Sanger Heart & Vascular Institute

Charlotte, North Carolina, United States

Site Status WITHDRAWN

Duke University Medical Center

Durham, North Carolina, United States

Site Status RECRUITING

Harrington Heart and Vascular Institute

Cleveland, Ohio, United States

Site Status RECRUITING

The Ohio State University Medical Center

Columbus, Ohio, United States

Site Status RECRUITING

Oregon Health & Science University

Portland, Oregon, United States

Site Status RECRUITING

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

UT Dell Medical School- Ascension

Austin, Texas, United States

Site Status RECRUITING

Baylor Scott & White Research Institution

Dallas, Texas, United States

Site Status RECRUITING

UT Southwestern- Dallas

Dallas, Texas, United States

Site Status RECRUITING

Houston Methodist Hospital

Houston, Texas, United States

Site Status RECRUITING

The University of Texas Health Houston

Houston, Texas, United States

Site Status RECRUITING

Baylor Scott & White The Heart Hospital - Plano

Plano, Texas, United States

Site Status RECRUITING

University of Utah

Salt Lake City, Utah, United States

Site Status RECRUITING

Sentara Cardiovascular Research Institute

Norfolk, Virginia, United States

Site Status RECRUITING

University of Washington

Seattle, Washington, United States

Site Status RECRUITING

CAMC Clinical Trials Center

Charleston, West Virginia, United States

Site Status RECRUITING

University of Wisconsin

Madison, Wisconsin, United States

Site Status RECRUITING

Medical College of Wisconsin

Milwaukee, Wisconsin, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Megan Roebuck, M.S.

Role: CONTACT

919-316-0628

Kady-Ann Steen-Burrell, Ph.D.

Role: CONTACT

919-530-9711

Facility Contacts

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Adam Beck, MD

Role: primary

Hasan Aldailami, MD

Role: primary

Ali Khoynezhad

Role: primary

Gregory Magee, MD

Role: primary

Jade Hiramoto, MD

Role: primary

Brett Reece, MD

Role: primary

Mel Sharafuddin, MD

Role: primary

Mohiuddin Cheema, MD

Role: primary

David Kuwayama, MD

Role: primary

Michol Cooper, MD

Role: primary

Dean Arnaoutakis, MD

Role: primary

Mark Eskandari, MD

Role: primary

Laura Healy, MD

Role: primary

Raghu Motaganahalli, MD

Role: primary

William Poulson, MD

Role: primary

Kristina Giles, MD

Role: primary

Caitlin Hicks, MD

Role: primary

Matthew Eagleton, MD

Role: primary

Matthew T Menard, MD

Role: primary

Andres Schanzer, MD

Role: primary

Bo Yang, MD

Role: primary

Loay Kabbani, MD

Role: primary

Eanas Yassa, MD

Role: primary

Nolan Cirillo-Penn, MD

Role: primary

Jonathan Bath, MD

Role: primary

Philip Batista, MD

Role: primary

Karim Salem, MD

Role: primary

Rami Tadros, MD

Role: primary

Doran Mix, MD

Role: primary

Timothy Carter, MD

Role: primary

Apostolos Tassiopoulos, MD

Role: primary

Palma Shaw, MD

Role: primary

G. Chad Hughes, MD

Role: primary

Jae S Cho, MD

Role: primary

Xiaoyi Teng, MD

Role: primary

Sherene Shalhub, MD

Role: primary

Nimesh Desai, MD

Role: primary

Babak Abai, MD

Role: primary

Ibrahim Sultan, MD

Role: primary

George Arnaoutakis, MD

Role: primary

John Eidt, MD

Role: primary

Michael Shih, MD

Role: primary

Marvin Atkins, MD

Role: primary

Firas Mussa, MD

Role: primary

Dennis Gable, MD

Role: primary

Nathan Droz, MD

Role: primary

David Dexter, MD

Role: primary

Benjamin Starnes, MD

Role: primary

Shadi Abu-halimah, MD

Role: primary

John Rectenwald, MD

Role: primary

Joe Hart, MD

Role: primary

Other Identifiers

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4UH3HL165017-02

Identifier Type: NIH

Identifier Source: secondary_id

View Link

5U24HL165029-02

Identifier Type: NIH

Identifier Source: secondary_id

View Link

Pro00113329

Identifier Type: -

Identifier Source: org_study_id

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