The invention provides a rotational atherectomy device having, in various embodiments, a flexible, elongated, rotatable drive shaft with at least one flexible or inflexible eccentric enlarged abrading and cutting head attached thereto which comprises an abrasive surface. When placed against stenotic tissue and rotated at high speed, the eccentric nature of the abrading and cutting head moves along an orbital path, opening the lesion to a diameter larger than the resting diameter of the enlarged abrading and cutting head. Preferably the abrading and cutting head has a center of mass spaced radially from the rotational axis of the drive shaft, facilitating the ability of the device to travel along an orbital path. The abrading and cutting head comprises proximal and/or distal radiused surfaces that facilitate cutting difficult stenosis material while minimizing trauma to the vessel. In some cases, the abrading and cutting head is made from a relatively dense metal.
