An atherectomy is done by inserting a catheter with a small blade on the end into an artery through a small incision. The small blade is used to scrape away the plaque within the artery. The plaque is collected within a small chamber at the end of the catheter where it can be easily removed from the artery. There are a couple of types of atherectomies including directional and rotational. Typically, we perform rotational atherectomies. We perform a directional atherectomy when we are able to identify exactly where the plaque is sitting using an inter-vascular ultrasound.