Abstract
Venous injury by a valvulotome is one of the risk factors for poor outcomes in peripheral arterial disease (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 inward 33 years ago, and have used it for 101 non-reversed translocated saphenous vein bypasses. The TF VenoCure2 (VC; Numata Optical Instruments Factory, Tokyo, Japan) 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 1 case was recovered. In another case, the most proximal valve was left uncut, which was resected by venotomy. Thus, the success rate of VC valvulotomy was 96.0% (97/101), including the 3 early occlusion cases. The in-hospital mortality rate was 2.2% (2/91); a patient on hemodialysis died of aspiration pneumonia, and an 89-year-old patient died of 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 with a single procedure with good pulsatile flow in 62 out of 67 cases (92.5%). The VC is a new device for safe and reliable valvulotomy in PAD surgery. (This is a secondary publication from J Jpn Coll Angiol 2025; 65: 55-61.).