Tissue modification devices and methods

An elongate, bimanually controlled tissue modification device for cutting tissue in a patient, the device comprising:

• a pair of flexible, elongate cutting members extending along an elongate length of the device;
• and
• a spacer, wherein the spacer is sized and configured to operate in one of two modes:
• a first mode, wherein the spacer is coupled to the cutting members such that it holds a portion of each of the two cutting members a distance from one another, and
• a second mode, wherein at least a portion of the spacer is moved away from a cutting member to allow the cutting members to cut further into tissue.

A method of modifying tissue, the method comprising:

• passing an elongate, flexible tissue-modification device at least partially around a target tissue,
• moving a tissue-modification region of the device against the target tissue by pulling the tissue-modification device from at least one end of the device;
• and
• cutting two discrete elongate troughs into the tissue with a pair of flexible elongate cutting members extending along the elongate length of the tissue modification region, wherein the elongate cutting members have a thickness and each of the elongate troughs are cut to a depth that is greater than the thickness of the cutting members.