Valvulotome

A valvulotome is a medical device used to destroy the venous valves in especially the great saphenous vein to allow for arterial flow.

Since the leg veins usually contain a number of valves that direct flow towards the heart, they cannot directly be used as graft, but if vein valves are removed the arterial blood can flow via the GSV to the lower leg - this is called an in situ graft procedure, a type of vascular bypass. [1] [2]

The valvulotome itself is a long, flexible catheter with a recessed cutting blade at its end for the destruction of venous valves. The valvulotome is inserted at the distal end of the vein, guided to the proximal end, then withdrawn. It is during withdrawal that the valves are destroyed. The blade is designed to prevent exposure of the vein intima to the sharp cutting surface to avoid damage to the vessel wall. It is often designed resembling a hook, with a blunt outer surface and a sharp inner surface that makes contact with the venous valve as the device is withdrawn, but not during insertion.[3]

References
  1. Donaldson MC1, Mannick JA, Whittemore AD. Femoral-distal bypass with in situ greater saphenous vein. Long-term results using the Mills valvulotome. Ann. Surg. 1991 May;213(5):457-64; discussion 464-5.
  2. Dardik H1, Vazquez R, Silvestri F, Ibrahim IM, Sussman B, Kahn M, Wolodiger F. Experience with a new valvulotome for lower-extremity revascularization procedures by the in situ method. Cardiovasc Surg. 1995 Apr;3(2):193-7.
  3. , Fogarty, Thomas J.; Thomas A. Howell & Jan R. Wicherski, "Valvulotome and method of using"


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