Clinical Impact of Using IMPROVE to Select Patients for Carotid Revascularisation

Narrowing of the carotid artery due to atherosclerosis with an unstable plaque can cause a stroke. Patients with carotid artery disease who have had a TIA or minor stroke and are at high risk of another stroke are often treated with surgery or stenting to remove the plaque. For lower-risk patients, medication alone is the better option, as surgery also carries risks. A new decision method, based on MRI detection of unstable plaques (IMPROVE), can better assess stroke risk and help determine which patients do or do not need surgery. We are investigating whether this method is at least as effective as the standard approach, which mainly considers the degree of narrowing. We expect that this new method will help reduce strokes and lower healthcare costs. Patients will be followed for several years to compare which method is better for health and costs.

NCT Number	NCT07556887
Lead Sponsor	Maastricht University Medical Center Collaborators: Academisch Ziekenhuis Maastricht, Amsterdam UMC, UMC Utrecht, Haaglanden Medical Centre, Isala, Radboud University Medical Center, Zuyderland Medical Centre, Albert Schweitzer Hospital, Rijnstate Hospital, Erasmus Medical Center
Conditions	Carotid Artery Stenosis Symptomatic, Ischemic Cerebral Infarction, Stroke Ischemic, Atheroscleroses, Stroke (CVA) or TIA, Stroke, Intraplaque Hemorrhage, TIA (Transient Ischemic Attack) +2 more
Enrollment	613 participants
Start Date	2026-03-31
Primary Completion	2028-08-31 (estimated)
Study Completion	2031-08-31 (estimated)
Updated on ClinicalTrials.gov	2026-05-15