Atherectomy is a procedure for opening coronary arteries blocked by plaque. Coronary atherectomy can be performed with several devices including a cutting devices (directional atherectomy) to shave plaque and store them in the catheter tip for later removal, a rotational atherectomy catheter which is a diamond-tipped catheter (burr) that rotates at 150,000-170,000 rpm drilling through the blockage and excimer Laser catheters to ablate plaque. These procedures are used for specific lesion types (calcifications, bifurcation lesions, ostial lesions,…). With stenting, atherectomy has become a niche procedure, however, it is being used more frequently in peripheral vascular interventions