The present disclosure is generally directed to novel bead geometries that can provide improved sanding efficiencies in rotational atherectomy procedures. The abrasive elements disclosed herein may open stenotic lesions to diameters that are substantially larger than the maximum diameter of the abrasive element. In some embodiments, the abrasive elements may open stenotic lesions to diameters that are substantially larger than the maximum diameter of the sheath from which the abrasive element is delivered through. In some embodiments the abrasive elements are configured to expand when the abrasive elements are rotated at high speeds. In some embodiments, the abrasive elements have local centers of mass that are positioned at opposite diagonal ends. Accordingly, the abrasive elements disclosed herein may have improved sanding ranges, reduce treatment times, and prevent re-stenosis.
