Thrombectomy Reduces Pulmonary Embolism Mortality but Unequal Access Outcomes Persist by Race and Income

Document Type

Conference Proceeding

Publication Date

3-2026

Publication Title

Journal of Vascular Surgery: Venous and Lymphatic Disorders

Abstract

Objective: To evaluate the association of catheter-directed thrombectomy with in-hospital mortality and examine disparities in its utilization across race and income levels in patients with acute pulmonary embolism (PE) with cor pulmonale, using National Inpatient Sample (NIS) data from 2016 to 2022. Methods: We analyzed 180,440 hospitalizations for PE with cor pulmonale in the NIS using survey-weighted logistic regression to assess thrombectomy’s association with mortality and disparities by race and income. Results: Thrombectomy was performed in 10.2% of cases, rising from 2.8% in 2016 to 21.1% in 2022 (P < .001), and was associated with lower mortality (adjusted odds ratio [OR], 0.73; P < .001). Table I shows stark racial disparities in mortality: Asian patients had the highest rates, ranging from 13.24% in the third income quartile to 18.18% in the lowest quartile, followed by Hispanic patients at 11.08% to 12.99%, Black patients at 9.03% to 10.07%, and White patients at 6.73% to 9.04%. Black patients had higher mortality than White patients across all income quartiles, for example, 10.07% vs 8.46% in the lowest quartile and 9.05% vs 6.73% in the highest quartile. Thrombectomy rates also varied (Table II): Black patients had the highest rates, from 10.89% in the lowest quartile to 12.47% in the third quartile, followed by White patients at 9.37% to 10.93%, Asian patients at 6.85% to 10.06%, and Hispanic patients at 6.52% to 9.04%. Hispanic patients had lower odds of receiving thrombectomy (OR, 0.61; P = .005). Mortality was higher for Hispanic (OR, 1.32; P = .001) and Asian (OR, 1.72; P = .001) patients compared with White patients. Higher income was linked to lower mortality (OR, 0.84; P = .005), especially for White patients. Conclusions: Asian and Hispanic patients face the highest mortality risks, followed by Black patients, who consistently have higher mortality than White patients. Despite higher thrombectomy rates among Black patients, Hispanic and Asian patients are less likely to receive this lifesaving intervention, reflecting barriers in access. These disparities underscore the need for targeted clinical strategies to ensure equitable delivery of thrombectomy, particularly for high-risk groups like Hispanic and Asian patients.

Volume

14

Issue

2

First Page

102434

Comments

2026 American Venous Forum Annual Meeting, February 28 - March 4, 2026, Denver, CO

Last Page

102434

DOI

10.1016/j.jvsv.2025.102434

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