Racial and Ethnic Diversity in Endovascular Thrombectomy Trials

The burden of acute ischemic stroke varies among racial and ethnic groups. Black adults face a higher incidence of stroke as well as higher rates of mortality. Thrombolytic therapy is under-utilized in Black adults, and recent data show that endovascular thrombectomy is also under-utilized for Black and Hispanic adults in the United States. Despite federal initiatives designed to promote the representation of diverse racial and ethnic groups in academic research, Black and Hispanic adults continue to be underrepresented in clinical trials conducted in the United States. Globally, the lack of standardization regarding race and ethnicity reporting makes it challenging to determine the overall diversity of trial enrollment. In this topical review, we provide an overview of racial and ethnic disparities in stroke incidence and clinical care with a focus on endovascular thrombectomy and follow this with a description of diversity reporting in endovascular thrombectomy trials. We conclude with opportunities for and barriers to increasing racial and ethnic diversity in endovascular thrombectomy trials.