A rotational thrombectomy wire for breaking up vascular thrombus or other obstructive material comprises a wire (30, 60, 130, 130, 260, 360) and a housing (12, 112, 112). The wire comprises a core (62) having a proximal portion and a distal portion, the distal portion having a smaller diameter than the proximal portion. A cable (80) extends distally of the core. A first coil (90) is attached to the distal portion of the cable, the first coil having a diameter larger than a diameter of the cable and having a coil covering material (87) positioned thereover. The wire is rotatable by a motor (52, 152, 152). The housing includes a motor to rotate the wire, the wire connectable to the motor by a user.
