The Effectiveness and Security of the Tapered 4-bladed Valvulotome (TF VenoCure2: VC) Used in Non-reversed Translocated Saphenous Vein Bypass Surgeries

Abstract

Venous injury by valvulotome is one of the risk factors for poor result of peripheral arterial diseases (PAD) with non-reversed saphenous vein bypasses. As I thought that outward-pointing blades might cause intimal damage or tributary laceration, I invented a new valvulotome with tapered 4-blades pointing inwards 33 years ago, and have used it for 101 non-reversed translocated saphenous vein bypasses. The VC injured 3 veins in the early days, which were easily repaired and used for bypasses. There were 3 cases of early thrombotic occlusion, of which only one case was recovered. In another case, the most proximal valve was left uncut, which was resected by venotomy. So the success rate of VC valvulotomy was 96.0% (97/101), including the 3 early occlusion cases. In-hospital mortality rate was 2.2% (2/91); a patient on hemodialysis from aspiration pneumonia, and an 89-year-old patient from deteriorated heart failure. No venous injuries occurred in the consecutive 74 cases during the recent 22 years. From the operative records, the VC cut all the valves by a single procedure with good pulsatile flow in 62 cases out of 67 cases (92.5%). The VC is a new device for safe and sure valvulotomy in the PAD surgery.