The Improve AD Trial

Dr. Ezra Schwartz (@ezraschwartz10) interviews Dr. Firas Mussa and Mr. Jake Howitt to discuss the IMPROVE-AD Trial, a landmark, multi-institutional study investigating treatment strategies for uncomplicated Type B Aortic Dissection (uTBAD).

The IMPROVE-AD Trial is a multicenter randomized trial funded by the NIH/NHLBI that compares thoracic endovascular aortic repair (TEVAR) plus optimal medical therapy (OMT) vs. OMT and surveillance with selective TEVAR in patients with uncomplicated TBAD. The trial aims to address critical gaps in evidence left by prior studies (INSTEAD-XL, ADSORB), with a unique focus on quality of life, cost-effectiveness, and genetic data.

Dr. Firas Mussa is a professor of Surgery at McGovern Medical School at UTHealth Houston. He previously served as the Director of the Vascular Surgery Residency and Fellowship programs at NYU Langone Health. Dr. Mussa earned his medical degree from the University of Baghdad, followed by general surgery training at Johns Hopkins University and a vascular surgery fellowship at Baylor College of Medicine. His research focuses on complex aortic pathology, and he serves as the principal investigator of the IMPROVE AD trial.

Mr. Jake Howitt is the Community Engagement Co-Chair of the IMPROVE AD trial and a leading patient advocate within the PCORI-funded Aortic Dissection Collaborative. As a survivor of aortic dissection, he is passionate about improving patient-provider communication and raising awareness of hereditary aortic disease. His work emphasizes the importance of education, empathy, and community-building in clinical research and care delivery.

Special thank you to Jacob Soucy (@JacobWSoucy).

Resources:

·       Treatment of Uncomplicated Type B Aortic Dissection: Optimal Medical Therapy vs TEVAR + Optimal Medical Therapy- https://journals.sagepub.com/doi/10.1177/15385744231184671?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed 

·       INSTEAD Trial - https://pubmed.ncbi.nlm.nih.gov/19996018/

·       INSTEAD-XL 5-Year Follow-Up - https://pubmed.ncbi.nlm.nih.gov/23922146/

·       ADSORB Trial - https://pubmed.ncbi.nlm.nih.gov/24962744/

·       Feasibility of a proposed randomized trial in patients with uncomplicated descending thoracic aortic dissection: Results of worldwide survey - https://pubmed.ncbi.nlm.nih.gov/27823685/

·       Treatment of AD: Meta-Analysis - https://pubmed.ncbi.nlm.nih.gov/29066151/

·       TEVAR vs Medical Therapy- https://pubmed.ncbi.nlm.nih.gov/36334259/

·       IMPROVE AD Trial website - https://improvead.org

·       John Ritter Foundation for Aortic Health - https://johnritterfoundation.org

·       Think Aorta US - https://thinkaorta.us

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