Surreal illustration of a fragmented bridge, representing healthcare disparities.

Bridging the Gap: Understanding and Addressing Racial Disparities in Aortic Aneurysm Repair

Elliot Brynn in Health & Wellness November 2025 • 4 min read.

"A comprehensive look at racial and ethnic disparities in endovascular aortic aneurysm repair (EVAR) and what can be done to ensure equitable access to care."

In an era of unprecedented medical advancements, healthcare disparities remain a persistent challenge. Nowhere is this more evident than in the realm of vascular surgery, where racial and ethnic inequalities continue to affect patient outcomes. The United States, a nation of diverse backgrounds, sees its population constantly evolving, making the need to address these disparities more critical than ever.

Endovascular aortic aneurysm repair (EVAR), a minimally invasive technique for treating aortic aneurysms, has revolutionized vascular surgery. Yet, despite its benefits, access to EVAR and its associated outcomes are not equally distributed across all racial and ethnic groups. Understanding the complex interplay of factors that contribute to these disparities is essential for creating a more equitable healthcare system.

This article delves into a study examining racial disparities in EVAR, shedding light on the challenges faced by minority populations and offering insights into potential solutions. By exploring the nuances of access to care, treatment modalities, and patient outcomes, we aim to foster a deeper understanding of this critical issue and inspire action towards a more just and inclusive healthcare landscape.

Unveiling the Disparities in EVAR

Surreal illustration of a fragmented bridge, representing healthcare disparities.

A recent study meticulously examined data from the Florida State Agency for Health Care Administration, analyzing 36,601 EVAR procedures performed between 2000 and 2014. The findings revealed significant racial and ethnic disparities in access to care, treatment patterns, and patient outcomes. The study categorized patients into non-Hispanic Whites, non-Hispanic African Americans, Hispanics, and other minorities to identify key differences.

The study found that:

Age and Gender: African Americans presented for EVAR at younger ages and had a significantly higher percentage of female patients compared to other groups.
Payer Source: African Americans relied more heavily on Medicaid as their primary payer source.
Comorbidity: Hispanics exhibited the highest comorbidity scores, indicating a greater burden of pre-existing health conditions.
Hospital Stay and Charges: African Americans experienced longer hospital stays and incurred the highest in-hospital total charges.

These disparities highlight the complex web of factors influencing access to and outcomes from EVAR. Socioeconomic status, cultural barriers, and systemic biases within the healthcare system may all play a role. Understanding these nuances is crucial for developing targeted interventions to address these inequalities.

Moving Towards Equitable Care

Addressing racial and ethnic disparities in EVAR requires a multifaceted approach involving healthcare providers, policymakers, and community stakeholders. By acknowledging the existence of these inequalities and working collaboratively to implement targeted interventions, we can strive towards a more equitable healthcare system where all patients have the opportunity to benefit from life-saving treatments, regardless of their race or ethnicity. This includes focusing on early detection, improving access to specialized care, and addressing the underlying socioeconomic factors that contribute to health disparities.

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This article is based on research published under:

DOI-LINK: 10.1016/j.avsg.2018.11.002, Alternate LINK

Title: Racial Disparities In Endovascular Aortic Aneurysm Repair

Subject: Cardiology and Cardiovascular Medicine

Journal: Annals of Vascular Surgery

Publisher: Elsevier BV

Authors: Adam Tanious, Nirmani Karunathilake, Joel Toro, Afif Abu-Hanna, Laura T. Boitano, Timothy Fawcett, Brian Graves, Peter Nelson

Published: 2019-04-01

Everything You Need To Know

What is Endovascular Aortic Aneurysm Repair (EVAR) and why is it important to understand disparities in its access and outcomes?

Endovascular aortic aneurysm repair, or EVAR, is a minimally invasive surgical technique used to treat aortic aneurysms. This procedure has become a cornerstone in vascular surgery due to its less invasive nature compared to traditional open surgery. However, despite its advancements, the distribution of its benefits is not uniform across all racial and ethnic groups. Access to EVAR and the associated outcomes exhibit disparities that need to be addressed.

In the study discussed, how were patients categorized by race and ethnicity to identify disparities in Endovascular Aortic Aneurysm Repair (EVAR)?

The study examining racial disparities in EVAR categorized patients into four main groups: non-Hispanic Whites, non-Hispanic African Americans, Hispanics, and other minorities. This categorization allowed researchers to identify key differences in access to care, treatment patterns, and patient outcomes among these distinct populations. For example, the payer source of these groups varied with African Americans relying heavily on Medicaid.

What were some of the key racial and ethnic disparities identified in the study concerning access, treatment, and outcomes related to Endovascular Aortic Aneurysm Repair (EVAR)?

The study revealed several key disparities. African Americans presented for EVAR at younger ages and had a higher percentage of female patients. They also relied more on Medicaid. Hispanics exhibited the highest comorbidity scores, suggesting a greater burden of pre-existing health conditions. Additionally, African Americans experienced longer hospital stays and incurred the highest in-hospital total charges. Addressing these disparities requires a nuanced approach.

What steps are necessary, involving healthcare providers and policymakers, to move toward more equitable care in Endovascular Aortic Aneurysm Repair (EVAR)?

Addressing racial and ethnic disparities in EVAR necessitates a multifaceted approach involving healthcare providers, policymakers, and community stakeholders. This includes focusing on early detection, improving access to specialized care, and addressing the underlying socioeconomic factors that contribute to health disparities. Collaborative efforts are essential to ensure that all patients, regardless of their race or ethnicity, have the opportunity to benefit from life-saving treatments. Further research into patient-specific factors and institutional biases are needed to have the best results.

What socioeconomic factors contribute to the racial and ethnic disparities observed in Endovascular Aortic Aneurysm Repair (EVAR), and how do these factors impact patient outcomes?

The study highlighted several socioeconomic factors contributing to disparities in EVAR, including payer source and comorbidity scores. African Americans' reliance on Medicaid suggests potential barriers to access and quality of care, while Hispanics' higher comorbidity scores may reflect the impact of chronic conditions on their health outcomes. These factors underscore the need for targeted interventions addressing socioeconomic determinants of health to promote equitable access to EVAR and improve patient outcomes.