Atherectomy device

1. A device comprising:

a) a longitudinal axis;

b) a broach comprising cutting teeth, said broach substantially coaxial with the longitudinal axis and said cutting teeth projecting substantially radially from said longitudinal axis;

c) a ramp wire substantially coaxial with the longitudinal axis, wherein at least a portion of said ramp wire is displaced from said longitudinal axis;

d) a drive rod substantially coaxial with the longitudinal axis; and

e) a reversing drive cam;

wherein at least a portion of the ramp wire is slidably enclosed by the broach along a ramp wire length,

wherein said reversing drive cam causes

i) distal-to-proximal axial translation of the broach over the ramp wire, followed by

ii) about 90 to about 180 degrees of axial rotation of the broach around the ramp wire, followed by

iii) proximal-to-distal axial translation of the broach over the ramp wire, followed by

iv) about 90 to about 180 degrees of axial rotation to the broach around the ramp wire; and followed by

v) optional repetition of steps (i) through (iv).

2. The device of claim 1 , wherein said broach comprises a helically-cut tube, and wherein said ramp wire is anchored to a distal end of the device.

3. The device of claim 2 , wherein said broach comprises proximal and distal attachment points and a length therebetween, at which attachment points the broach is attached to the drive rod and over which length the broach is not attached to the drive rod.

4. The device of claim 3 , wherein said length is sufficient to accommodate the displacement of the ramp wire from the longitudinal axis.

5. The device of claim 3 , further comprising a cylinder, wherein said cylinder:

a) is substantially coaxial with the longitudinal axis;

b) at least partially encloses the broach, ramp wire, and drive rod; and

c) further comprises a window, said window exposing at least a portion of said broach, ramp wire, and drive rod.

6. The device of claim 5 , wherein said cylinder further comprises:

a) at least one fluid in-flow lumen in fluid communication with said window;

b) at least one fluid out-flow lumen in fluid communication with said window;

c) a guide-wire lumen; and

d) a chamber in fluid communication with said window, said fluid in-flow and out-flow lumens, and said guide-wire lumen.

7. The device of claim 6 , further comprising an opposition sleeve.

8. The device of claim 6 , further comprising at least one planetary gear pack, an infusion pump, and an aspiration pump.

9. A method for modifying a body lumen of a mammal in need thereof, the method comprising:

a) inserting the device of claim 1 into said body lumen; and

b) operating said reversing drive cam, thereby causing;

i) distal-to-proximal axial translation of the broach over the ramp wire, followed by

ii) about 90 to about 180 degrees of axial rotation of the broach around the ramp wire, followed by

iii) proximal-to-distal axial translation of the broach over the ramp wire, followed by

iv) about 90 to about 180 degrees of axial rotation to the broach around the ramp wire; and followed by

v) optional repetition of steps (i) through (iv).

10. The method of claim 9 , wherein said device further comprises a cylinder, wherein said cylinder:

a) is substantially coaxial with the longitudinal axis;

b) at least partially encloses the broach, ramp wire, and drive rod; and

wherein said cylinder further comprises:

c) a window, said window exposing at least a portion of said broach, ramp wire, and drive rod;

d) at least one fluid in-flow lumen in fluid communication with said window;

e) at least one fluid out-flow lumen in fluid communication with said window;

f) a guide-wire lumen; and

g) a chamber in fluid communication with said window, said fluid in-flow and out-flow lumens, and said guide-wire lumen.

11. The method of claim 10 , wherein said modifying comprises removing plaque from said body lumen.

12. The method of claim 10 , wherein said modifying comprises enlarging, making round, or making patent said body lumen.