The present application pertains generally to medical systems and methods for creation of an autologous tissue valves within a mammalian body. In some embodiments, a system for creating an endoluminal valve from a blood vessel wall is provided. The system includes a tubular assembly having a longitudinal axis, a proximal end, a distal portion with a distal end, and a first lumen extending from the proximal end to a distal port located proximate the distal portion. The distal portion can have a supporting surface that extends in a longitudinal direction and is offset from a surface of the tubular assembly proximal the distal port. The system can further include a tissue dissection probe disposed within the first lumen.