# US 11,998,468 B2 · Methods of intracerebral implant delivery > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,998,468 B2 - Document ID: US11998468B2 - Status: Granted - Kind: B2 - Application number: 17/481,639 - Filed: 2021-09-22 - Published: 2022-06-09 - Granted: 2024-06-04 - Earliest claimed: 2015-07-24 - Assignees: Route 92 Medical, Inc. - Applicants: Route 92 Medical, Inc. - Inventors: Tony M. Chou; Joey English - Web page: https://patentgrep.com/patent/US11998468B2 ## CPC - A61F 2/966: with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod - A61B 17/12109: {in a blood vessel} - A61B 17/12118: {for positioning in conjunction with a stent} - A61B 17/1214: {Coils or wires} - A61F 2/82: Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents (stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07) - A61F 2/95: Instruments specially adapted for placement or removal of stents or stent-grafts - A61B 17/12036: {partial occlusion} - A61B 17/12113: {within an aneurysm} - A61B 2017/1205: {Introduction devices} - A61F 2/07: Stent-grafts - A61F 2/915: with bands having a meander structure, adjacent bands being connected to each other - A61F 2002/068: {Modifying the blood flow model, e.g. by diffuser or deflector} - A61F 2002/91558: {connected peak to peak} - A61F 2002/91566: {connected trough to trough} - A61F 2002/91575: {connected peak to trough} - A61F 2220/0016: with sharp anchoring protrusions, e.g. barbs, pins, spikes - A61F 2230/0091: helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract The method of delivering an implant in an intracranial vessel includes deploying an anchor of a tethering device in an anchoring vessel forming a first fixation point and advancing a guide-sheath to a location near the anchoring vessel. The tethering device has a tether extending proximally from the anchor and the guide-sheath has at least one lumen. The method includes attaching the guide-sheath to the tether of the tethering device forming a second fixation point proximal to the first fixation point, delivering an implant through the lumen of the guide-sheath towards a treatment site distal to the first fixation point and located within an intracranial vessel, and deploying the implant at the treatment site. Related devices, systems, and methods are also provided. ## Claims ### Claim 1 A method of delivering an expandable implant in an intracranial vessel, the method comprising: advancing a guidewire near an anchoring vessel; exchanging the guidewire for a tethering device, wherein the tethering device includes a tether extending proximally from an anchor; deploying the anchor of the tethering device in the anchoring vessel forming a first fixation point, wherein the anchor allows blood to flow past the anchor in the anchoring vessel when deployed; advancing a guide-sheath over the tether of the tethering device to position an opening from the guide-sheath near an entrance of a target vessel bifurcating from the anchoring vessel; attaching the guide-sheath to the tether of the tethering device forming a second fixation point proximal to the first fixation point; and delivering an implant through the guide-sheath to a treatment site distal to the first fixation point within the intracranial vessel. ### Claim 2 (depends on 1) The method of claim 1, wherein the anchor is deployed at an anchoring site in the anchoring vessel distal to the entrance of the target vessel. ### Claim 3 (depends on 1) The method of claim 1, wherein the guide-sheath includes a lumen to receive at least a portion of the tether, and wherein the lumen is different or the same as a lumen through which the implant is delivered. ### Claim 4 (depends on 1) The method of claim 1, wherein delivering the implant through the guide-sheath tensions the tether between the anchor deployed in the anchoring vessel and the second fixation point. ### Claim 5 (depends on 1) The method of claim 1, wherein the implant is a balloon-expandable stent, a self-expanding stent, or a flow diverter. ### Claim 6 (depends on 1) The method of claim 1, wherein the treatment site is an aneurysm or a stenosis. ### Claim 7 (depends on 1) The method of claim 1, further comprising preventing prolapse of the guide-sheath during delivery of the implant. ### Claim 8 (depends on 1) The method of claim 1, further comprising resisting tension stored in the guide-sheath during delivery of the implant. ### Claim 9 (depends on 1) The method of claim 1, wherein the implant is a self-expanding stent and deploying the implant at the treatment site comprises unsheathing the self-expanding stent by withdrawing proximally a constraint. ### Claim 10 (depends on 9) The method of claim 9, further comprising preventing the self-expanding stent from missing the treatment site during unsheathing. ### Claim 11 (depends on 1) The method of claim 1, further comprising removing the anchor from the anchoring vessel; and removing the guide-sheath. ### Claim 12 (depends on 1) The method of claim 1, wherein deploying the anchor comprises deploying the anchor from a low profile configuration to a higher profile configuration. ### Claim 13 (depends on 1) The method of claim 1, wherein attaching the guide-sheath to the tether comprises using a tether gripper at the second point of fixation to attach the guide-sheath to the tether of the tethering device. ### Claim 14 (depends on 1) The method of claim 1, further comprising advancing a catheter over the guidewire into the anchoring vessel prior to exchanging the guidewire. ### Claim 15 (depends on 14) The method of claim 14, wherein advancing the guide-sheath over the tether comprises advancing the guide-sheath over the catheter and removing the catheter from the guide-sheath prior to attaching the guide-sheath to the tether.