Valvulotome and method of using

A valvulotome for disrupting the valves of a vein, the valvulotome comprising:

• an elongate blade mounting member defining an axis, the blade mounting member including a distal portion;
• a thin, scythe-shaped cutting blade defining a plane, the cutting blade being mounted relative to the blade mounting member with the plane on the axis, the cutting blade including:
• a fixed end fixedly attached to the distal portion of the blade mounting member,
• a sharpened edge facing towards the blade mounting member, arcing outwards and proximally from the distal portion of the blade mounting member, and terminating in a proximal portion spaced from the blade mounting member,
• a blunt back edge opposite the sharpened edge, and
• a free end opposite the fixed end, the free end connecting the blunt back edge to the proximal portion of the sharpened edge and including a blunt proximal-facing portion forming a continuation of the blunt back edge;
• and
• extendable means for selectively moving the cutting blade laterally in the vein.

A valvulotome for disrupting the valves of a vein, the valvulotome comprising:

• an elongate blade mounting member defining an axis, the blade mounting member including a distal portion;
• a thin, scythe-shaped cutting blade defining a plan, the cutting blade being mounted relative to the blade mounting member with the plane on the axis, the cutting blade including:
• a fixed end fixedly attached to the distal portion of the blade mounting member,
• a sharpened edge facing towards the blade mounting member, arcing outwards and proximally from the distal portion of the blade mounting member, and terminating in a proximal portion spaced from the blade mounting member,
• a blunt back edge opposite the sharpened edge, and
• a free end opposite the fixed end, the free end connecting the blunt back edge to the proximal portion of the sharpened edge and including a blunt proximal-facing portion forming a continuation of the blunt back edge;
• wherein the blade mounting member further comprises:
• an elongate shaft, defining the axis and having a distal portion;
• and
• an extension extending distally from the distal portion of the shaft in a laterally offset relation thereto, the extension including a distal portion whereto the fixed end of the cutting blade is fixedly attached;
• and
• wherein the extension is shaped to provide a blade recess accomodating the sharpened edge and the free end of the cutting blade.

A valvulotome for disrupting the valves of a vein, the valvulotome comprising:

• an elongate blade mounting member defining an axis, the blade mounting member including a distal portion;
• a thin, scythe-shaped cutting blade defining a plane, the cutting blade being mounted relative to the blade mounting member with the plane on the axis, the cutting blade including:
• a fixed end fixedly attached to the distal portion of the blade mounting member,
• a sharpened edge facing towards the blade mounting member, arcing outwards and proximally from the distal portion of the blade mounting member, and terminating in a proximal portion spaced from the blade mounting member,
• a blunt back edge opposite the sharpened edge, and
• a free end opposite the fixed end, the free end connecting the blunt back edge to the proximal portion of the sharpened edge and including a blunt proximal-facing portion forming a continuation of the blunt back edge;
• wherein the blade mounting member further comprises:
• an elongate shaft, defining the axis and having a distal portion;
• and
• an extension extending distally from the distal portion of the shaft in a laterally offset relation thereto, the extension including a distal portion whereto the fixed end of the cutting blade is fixedly attached;
• and
• extendable means for selectively moving the cutting blade laterally in the vein.

A valvulotome for disrupting the valves of a vein, the valvulotome comprising:

• an elongate blade mounting member defining an axis, the blade mounting member including a distal portion;
• a thin, scythe-shaped cutting blade defining a plane, the cutting blade being mounted relative to the blade mounting member with the plane on the axis, the cutting blade including:
• a fixed end fixedly attached to the distal portion of the blade mounting member,
• a sharpened edge facing towards the blade mounting member, arcing outwards and proximally from the distal portion of the blade mounting member, and terminating in a proximal portion spaced from the blade mounting member,
• a blunt back edge opposite the sharpened edge, and
• a free end opposite the fixed end, the free end connecting the blunt back edge to the proximal portion of the sharpened edge and including a blunt proximal-facing portion forming a continuation of the blunt back edge;
• and
• wherein the blade mounting member further comprises:
• an elongate shaft, defining the axis and having a distal portion;
• and
• a substantially cylindrical haft extending distally from the distal portion of the shaft, the haft including:
• a blunt nose remote from the elongate shaft,
• a curved surface,
• a blade recess formed in the curved surface, and
• a distal portion whereto the fixed end of the sharpened blade is fixedly attached with the cutting edge and the free end in the blade recess.

A valvulotome for disrupting the valves of a vein, the valvulotome comprising:

• an elongate blade mounting member defining an axis, the blade mounting member including a distal portion;
• a thin, scythe-shaped cutting blade defining a plane, the cutting blade being mounted relative to the blade mounting member with the plane on the axis, the cutting blade including:
• a fixed end fixedly attached to the distal portion of the blade mounting member,
• a sharpened edge facing towards the blade mounting member, arcing outwards and proximally from the distal portion of the blade mounting member, and terminating in a proximal portion spaced from the blade mounting member,
• a blunt back edge opposite the sharpened edge, and
• a free end opposite the fixed end, the free end connecting the blunt back edge to the proximal portion of the sharpened edge and including a blunt proximal-facing portion forming a continuation of the blunt back edge;
• and
• wherein the cutting blade includes opposed sides perpendicular to the blunt back edge, the sides being wider at the fixed end of the cutting blade than at the free end of the cutting blade.

A valvulotome for disrupting the valves of a vein, the valvulotome comprising:

• an elongate shaft defining an axis, the shaft including a distal end;
• a substantially cylindrical haft extending distally from the distal end of the shaft and terminating in a blunt nose, the haft including:
• a distal portion,
• a curved surface,
• a blade recess formed in the curved surface, and
• a bore communicating with a slot formed in a portion of
• the curved surface opposite the blade recess;
• a thin, scythe-shaped cutting blade defining a plane, the cutting blade being mounted relative to the haft with the plane on the axis, the cutting blade including:
• a fixed end fixedly attached to the distal portion of the haft,
• a sharpened edge facing into the blade recess, arcing outwards and proximally from the distal portion of the haft, and terminating in a proximal portion in the blade recess and accommodated thereby,
• a blunt back edge opposite the sharpened edge, and
• a free end opposite the fixed end, the free end connecting the blunt back edge to the proximal portion of the sharpened edge and including a blunt proximal-facing portion forming a continuation of the blunt back edge;
• a guide wire slidably mounted in the bore and including an extending portion adjacent the slot;
• and
• means for selectively sliding a proximal portion of the guide wire relative to the bore, the selective sliding selectively extending the extending portion of the guide wire from the slot.

A method of performing a valvotomy in a vein having a valve comprising a leaflet joined to the vein, the leaflet and the vein forming a valve pocket having an apex, the leaflet including an edge remote from the apex, the method comprising the steps of:

• providing a valvulotome including:
• an elongate blade mounting member defining an axis and including a distal portion, and
• a thin, scythe-shaped cutting blade defining a plane and being mounted relative to the blade mounting member with the plane on the axis, the cutting blade including:
• a fixed end fixedly attached to the distal portion of the blade mounting member;
• a sharpened edge facing towards the blade mounting member, arcing outwards and proximally from the distal portion of the blade mounting member, and terminating in a proximal portion spaced from the blade mounting member;
• a blunt back edge opposite the sharpened edge;
• and
• a free end opposite the fixed end, the free end connecting the blunt back edge to the proximal portion of the sharpened edge and including a blunt proximal-facing portion forming a continuation of the blunt back edge;
• moving the cutting blade towards the valve to locate the free end of the cutting blade at the apex;
• piercing the leaflet at the apex using a sharpened portion of the free end of the cutting blade;
• and
• applying a tensile force between the cutting blade and the leaflet to cut the leaflet from the apex to the edge.