(A1202) Analysis of Inspire Device Explantation: Patient Demographics and Temporal Metrics

Introduction: Obstructive sleep apnea remains a significant clinical concern, with hypoglossal nerve stimulation (Inspire) serving as an alternative therapy for patients intolerant to CPAP. Those who choose to have the device explanted represent the population least satisfied with their experience. This study examines the time to explantation, demographic distribution, and related factors for Inspire devices in a database cohort.

Methods: The PearlDiver Mariner Patient Claims Database, which captures 170 million patients across all payers between 2010 and 2022 was queried for all Inspire implantions using CPT code 64582. Out of this cohort, explantations were queried using CPT code 64584. This code was implemented January 1st, 2022, therefore this search captured patients explanted in 2022 alone. Demographics and data on time to explantation were collected and analyzed for descriptive statistics.

Results: 3025 patients were identified who underwent Inspire implantation, 29 of which subsequently underwent device explantation. Overall, the rate of explantation was 0.96%. The explanted patients ranged in age from 27 to 80 years old. The median time to explantation was 83 days (IQR: 63-126 days, range: 30-171 days). 69% of explanted patients were male.

Conclusions: The Inspire device explantation timing suggests a wide range of patient experiences. All explanted devices were removed by 6 months post-procedure. Notably, the rate of explantation remains exceedingly low. These data underscore the necessity for personalized patient monitoring post-implantation and further studies to refine patient selection criteria and optimize device performance. While effective in many, the variability in explantation timelines calls for enhanced predictive models to ensure post-operative patient satisfaction.