INTRODUCTION
Ever since its first description in 1994 by Dake and colleagues,
thoracic endovascular aortic repair (TEVAR) has become the standard of
care for the treatment of various pathologies involving the descending
thoracic aorta (DTA), including aneurysm, acute dissection, intramural
hematoma, and aortic rupture . Aided by technological advances and
increasing operator familiarity with endovascular approaches, TEVAR has
been associated with improved short-term outcomes compared to open
surgical repair, including operative mortality, spinal cord ischemia,
acute kidney injury, and cardiac and pulmonary complications
Nevertheless, access to surgical procedures and their benefits is often
inequitable due to structural disparities at the health systems level .
For example, racial disparities have persisted in the utilization of 9
major surgical procedures, including coronary angioplasty, spinal
fusion, carotid endarterectomy, appendectomy, colorectal resection,
coronary artery bypass grafting, total hip arthroplasty, total knee
arthroplasty, and worsened for one-third of them from 2012-2017 period .
Likewise, the Transcatheter Valve Therapy (TVT) Registry suggests
minorities have been underrepresented among the recipients of
transcatheter aortic valve replacement (TAVR) .
However, the incursion of TEVAR technology into medical practice
suggested a process of ”democratizing technology.” Historically, black
patients were more likely to undergo open repair for thoracic aortic
aneurysms (TAA) at low-volume hospitals with higher operative mortality
than white patients (13). This paradigm was challenged by two reports,
including data from 1999 to 2008, were we could observed a setting-off
of traditional racial disparities with TEVAR utilization . Given that
more than a decade has already passed, our objective is to reevaluate if
TEVAR continues to be a procedure where access to surgical services is
not affected by racial differences using a contemporary database.