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Racial and Ethnic Diversity in Endovascular Thrombectomy Trials
Gisele Sampaio Silva1,2, Eva Rocha1, Amol Mehta3
1Department of Neurology and Neurosurgery Division of Vascular Neurology and Neurointensive Care Universidade Federal de São Paulo (UNIFESP) São Paulo Brazil.
Stroke (Hoboken, N.J.)
|January 26, 2026
Summary
Black and Hispanic adults experience higher stroke risks and mortality. Underutilization of treatments like endovascular thrombectomy and underrepresentation in clinical trials highlight significant racial disparities in stroke care.
Area of Science:
- Neurology
- Public Health
- Clinical Research
Background:
- Acute ischemic stroke burden disproportionately affects Black adults, with higher incidence and mortality rates.
- Thrombolytic therapy and endovascular thrombectomy are underutilized in Black and Hispanic adults in the U.S.
- Racial and ethnic minorities remain underrepresented in U.S. clinical trials despite federal diversity initiatives.
Purpose of the Study:
- To review racial and ethnic disparities in stroke incidence and clinical care, focusing on endovascular thrombectomy.
- To describe the reporting of diversity in endovascular thrombectomy trials.
- To identify opportunities and barriers to increasing diversity in these trials.
Main Methods:
- Topical review of existing literature on stroke disparities.
- Analysis of data on endovascular thrombectomy utilization and clinical trial diversity.
- Examination of global race and ethnicity reporting standards.
Main Results:
- Significant disparities exist in stroke incidence, treatment utilization, and clinical trial representation for Black and Hispanic adults.
- Lack of standardized race and ethnicity reporting globally complicates assessment of trial diversity.
- Underrepresentation persists despite efforts to promote diversity in research.
Conclusions:
- Addressing racial and ethnic disparities in stroke care, particularly for endovascular thrombectomy, is critical.
- Standardized reporting and targeted strategies are needed to improve diversity in clinical trials.
- Overcoming barriers is essential to ensure equitable access to stroke treatments and research participation.
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