A high-speed
atherectomy device is disclosed, for abrading a blockage (
stenosis) in the interior of a lumen (
artery). The device uses a rapidly rotating
drive shaft that includes an eccentric
abrasive element that has its
center of mass laterally offset from the
rotational axis of the
drive shaft. As the
drive shaft rotates,
centrifugal force drives the eccentric
abrasive element outward, so that it traces an abrading
diameter at high rotational speeds that is larger than its rest
diameter. The drive shaft includes counterweights on both sides of the
abrasive element, which may stabilize operation at high rotational speeds. In some cases, the counterweights are also eccentric, with their centers of
mass laterally offset from the
rotational axis in the opposite direction as that of the abrasive element. The counterweights are longitudinally separated from the abrasive element, and in some cases, the separations are adjustable and / or controllable. In some cases, the guide wire may be retracted prior to or during the high-speed rotation of the drive shaft, with the retraction being to the distal counterweight, the abrasive element, the proximal counterweight, or beyond the proximal counterweight.