Using an MRI-based risk model to choose carotid artery surgery after stroke
Tests an MRI-based method for choosing surgery in people with symptomatic carotid narrowing.
Plain-language title generated from the registry record
Registry title: Clinical Impact of Using IMPROVE to Select Patients for Carotid Revascularisation
Key facts
- Where
- Amsterdam, Arnhem, Dordrecht, Heerlen, Maastricht, Nijmegen, Rotterdam, The Hague, Utrecht, and Zwolle, NetherlandsSee the 10 sites
Where in Netherlands
- Amsterdam UMCAmsterdam, NetherlandsNot yet recruiting
- RijnstateArnhem, NetherlandsNot yet recruiting
- Albert Schweitzer ZiekenhuisDordrecht, NetherlandsNot yet recruiting
- ZuyderlandHeerlen, NetherlandsNot yet recruiting
- Maastricht UniversityMaastricht, NetherlandsTaking people
- Radboud UMCNijmegen, NetherlandsNot yet recruiting
- Erasmus MCRotterdam, NetherlandsNot yet recruiting
- Haaglanden MCThe Hague, NetherlandsNot yet recruiting
- Utrecht UMCUtrecht, NetherlandsNot yet recruiting
- IsalaZwolle, NetherlandsNot yet recruiting
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Maastricht University Medical Center
- Trial code
- NCT07556887
- Record updated
- 15 May 2026
- Original description
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.Read full original descriptionShow less
Clinical Impact of the Use of IMPROVE for Selection of Patients for Carotid Revascularisation: a Randomized Controlled Multicentre Non-inferiority Trial in Symptomatic Patients With 30-99% Carotid Stenosis
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.
Inclusion: Mentally competent; 18 years or older; Recent (<30 days) stroke (modified Rankin scale ≤3) or TIA; Ipsilateral 30-99% atheromatous stenosis at the carotid bifurcation assessed using non-invasive imaging according to NASCET criteria; Life expectancy >5 years; Patient and stenosis are suitable for carotid revascularisation; Patient is agreeable to randomisation and willing to accept either IMPROVE-based or CAU-based selection method for carotid revascularisation.
Exclusion: Cardiac source of embolism; Carotid stenosis caused by non-atherosclerotic disease e.g. dissection, fibromuscular disease or neck radiotherapy; MRI contra-indications; Pregnancy.