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

Figures

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  Fig. 1. The SC has blades facing outwards, contrary to the VT or VC with tapered 4 blades facing inwards. (A) SC (LeMaitre Vascular, Burlington, MA, USA) with the sharp blades facing outwards. (B) The drawing from the Patent Certificate of the VT (original type) with the blades facing inwards. (C) VC (Numata Optical Instruments Factory, Tokyo, Japan) (improved type) with the blades facing inwards. SC, self-sizing, self-centering valvulotome; VT, tapered 4-bladed valvulotome; VC, TF VenoCure2

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  Fig. 2. How to use the TF VenoCure2 (VC). (A) Choose the minimal-sized VC (Numata Optical Instruments Factory, Tokyo, Japan), no greater than the expanded SVG. After the proximal anastomosis is completed, the VC should be inserted from the distal end of the SVG. (B) The VC should be blocked by the assistant’s thumb and finger so as not to extend beyond the proximal anastomotic line. When the operator withdraws the VC, the assistant should hold the proximal side of the graft to avoid damaging the SVG or the proximal anastomosis. (C) The assistant should hold the “neck” of the VC gently so as to catch and cut the valves securely. If you feel resistance during withdrawal, you must push the VC back slightly, rotate it a little, and try again slowly. (D) At the instant you cut the valves, you can feel a slight cutting resistance , and the pulse will progress to the next competent valve. In most cases, a single procedure yields a good pulsatile flow with successful valvulotomy. When the flow seems poor, the flow should be repeated. SVG, saphenous vein graft