Atherectomy devices and methods

A rotational atherectomy apparatus comprising:

• a handle assembly including a housing, a rotatable member disposed within the housing, and a carriage to which the rotatable member is rotatably attached, wherein the carriage is longitudinally translatable relative to the housing;
• a sheath having a proximal end attached to a distal end of the housing and defining a longitudinal sheath lumen;
• an elongate flexible drive shaft coupled to the rotatable member such that rotation of the rotatable member drives the drive shaft to rotate within the longitudinal sheath lumen, the drive shaft comprising a torque-transmitting coil extending from the housing, an array of same-shaped eccentric abrasive burrs fixed to a distal portion of the torque-transmitting coil and each of the same-shaped eccentric abrasive burrs having a respective center of mass offset from a longitudinal axis of the torque-transmitting coil, and a distal concentric element having a different shape than the same-shaped eccentric abrasive burrs and being concentrically mounted to the distal portion of the torque-transmitting coil at a position distal from the array of the same-shaped eccentric abrasive burrs, wherein when the drive shaft is driven to rotate about an axis of rotation at 20,000 rpm to 160,000 rpm, the array of same-shaped eccentric abrasive burrs and the distal concentric element rotate together with the torque-transmitting coil such that the array of same-shaped eccentric abrasive burrs move in an orbital path offset from an axis of rotation while the distal concentric element remains generally at the axis of rotation;
• a guidewire access port positioned at a proximal end the housing of the handle assembly and axially aligned with the longitudinal sheath lumen extending from the distal end the housing of the handle assembly, wherein the guidewire access port is configured to receive a guidewire movable within the torque-transmitting coil of the drive shaft;
• a fluid delivery port positioned in the housing of the handle assembly at a location spaced apart from the guidewire access port and axially offset from the longitudinal sheath lumen extending from the distal end the housing of the handle assembly, wherein the fluid delivery port is configured to provide fluid into the longitudinal sheath lumen;
• and
• a depressible actuator configured to activate rotation of the drive shaft and being mounted to the carriage such that both the depressible actuator and the carriage are simultaneously translatable relative to the housing while the actuator is in a depressed state to activate rotation of the drive shaft within the longitudinal sheath lumen.