A tool that has an introducer having a space therein and a distal aperture at the distal end thereof, and a spike movable within the introducer, may be used in a surgical method for treating a vessel wall. A tissue plug may be removed from the vessel wall with the spike, whereby an opening remains in the vessel wall. The spike then may be moved within the space in the introducer in a direction away from the longitudinal centerline of the distal aperture. An object then may be delivered through the introducer and out of the distal aperture to the opening in the vessel wall.