INPIREd by data: Learnings from INSPIRE-A and INSPIRE-S REGISTRIES

Real-world clinical experience in stroke and aneurysm treatment: key registries for a deeper understanding of devices, procedures and protocols

We know that registries - which gather data from real-life clinical practice – are critical tools offering a more profound grasp of what we do. In this wrap-up of the “INSPIREd by data” Medtronic symposium during the recent LINNC Paris 2023 , Marc RIBO and Jildaz CAROFF discuss two registries INSPIRE-S and INSPIRE- A and their impact on how we practice today.

Jildaz CAROFF presents INSPIRE- A, an observational platform supported by Medtronic whose goal is to allow for a permanent evaluation of new devices used for aneurysm treatment. Here, looking at antithrombotic protocols, Dr CAROFF asked what the optimal duration of dual antiplatelet therapy after the use of a flow diverter would be, observing that while the device was seen to be safe and effective, no conclusive evidence can be drawn to answer the question of DAPT duration.

Turning to Marc RIBO, we learn about the INSPIRE-S international registry – gathering data on all stroke patients treated with a Medtronic device – the Solitaire or React Aspiration Catheter – with a specific focus here on the question of combination therapy. Results presented by Dr RIBO showed a final canalization of over 90%, with striking rates of first-pass canalization using these two devices.

Beyond the question of the devices, Drs RIBO and CAROFF discuss the very nature of a registry itself: First, the definition of a good registry with an external core lab reviewing all the images and adjudication of events by an independent clinical event committee. And what is the true value of these registries? How do they complement the data gained from randomized controlled trials? Do they help generate hypotheses? For instance, in the case of the INSPIRE registries, Marc RIBO mentions results of the use of manual vs pump aspiration or distal access catheter size that can be useful for practice or inform future studies allowing us to see ways that registries can have an impact on the design of future trials. Interested? Listen to this thought-provoking discussion now!

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