A system for forming an autologous leaflet at a dissection plane between two layers of tissue in a wall of a vessel, the system comprising: a conduit mechanism (2) having a longitudinal axis, a proximal portion, a distal portion, and an internal lumen (6) terminating at an exit port (7), wherein the exit port (7) is located at the distal portion of the conduit mechanism (2)； a sub-intimal access mechanism (18) configured to extend through the internal lumen (6) and out of the exit port (7) to penetrate a tissue layer (60)； and a sub-intimal pocket creation mechanism (32) comprising (a) an elongated member (33) configured to be slideably disposed through the lumen of the conduit mechanism, (b) an expandable portion at a distal portion of the elongated member (33), and (c) a backward-facing cutting mechanism (47), wherein the sub-intimal pocket creation mechanism is sized for insertion through an opening between two tissue layers (60, 61) to access the dissection plane and actuated to move laterally within the dissection plane.血管の組織を操作するデバイスは、近位端部および遠位端部を有する伸長した部材と、伸長した部材の遠位端部にあり、血管の内壁に対して係合する、尖っていない先端を有するガイド部材と、伸長した部材の遠位端部にある組織切断デバイスを含み、組織切断デバイスはガイド部材の尖っていない先端近くに尖った先端を有する。
