A system for ablation and removal of occlusions from blood vessels is provided. Laser cutting systems and mechanical cutting systems are provided in catheter devices, the cutting systems operable to ablate, cut, dislodge, and otherwise remove occlusions within a blood vessel that may limit or prevent proper circulation. Pulsed aspiration systems are further provided, the pulsed aspiration systems operable to remove ablated, cut, or dislodged material without excessive or unnecessary removal of blood and fluid.