A high-speed rotational atherectomy device for opening a stenosis in an artery having a given diameter, comprising: a guide wire having a maximum diameter less than the diameter of the artery; a flexible elongated, rotatable drive shaft (20; 20A) advanceable over the guide wire, the drive shaft (20; 20A) having a rotational axis; and at least one eccentric abrading head of single-piece unitary prefabricated construction attached to the drive shaft (20; 20A), the abrading head comprising a maximum nominal resting diameter, a geometric center spaced radially from the rotational axis and a center of mass spaced radially from the rotational axis as a consequence of the radial spacing of the geometric center away from the rotational axis, proximal (30; 30A), intermediate (35; 35A) and distal (40; 40A) portions, wherein the proximal portion (30; 30A) comprises a proximal outer surface, the intermediate portion (35; 35A) comprises an intermediate outer surface and the distal portion (40; 40A) comprises a distal outer surface, the proximal outer surface having diameters that increase distally, the distal outer surface having diameters that decrease distally, and the intermediate outer surface being cylindrical, wherein the proximal portion (30; 30A) and the intermediate portion (35; 35A) intersect and define an edge at the intersection between the proximal portion (30; 30A) and the intermediate portion (35; 35A) and wherein the distal portion (40; 40A) and the intermediate portion (35; 35A) intersect and define an edge at the intersection between the distal portion (40; 40A) and the intermediate portion (35; 35A), wherein the eccentric abrading head comprises a nominal diameter and wherein at least the intermediate outer surface comprise a tissue removal section and wherein the abrading head defines a drive shaft lumen therethrough, the drive shaft (20; 20A) at least partially traversing the drive shaft lumen, wherein the portion of the drive shaft (20; 20A) traversing the drive shaft lumen and attaching thereto comprises at least two sections, each section attached to the drive shaft lumen with a gap between the at least two drive shaft sections, and a hollow cavity (25; 25A) comprising a size and shape for customization of the positioning of the center of mass of the at least one eccentric abrading head away from the drive shaft's rotational axis for stimulation of orbital rotational pathing of the at least one eccentric abrading head, wherein the tissue removing section rotates through a path with a maximum rotational diameter that is between about 200% and about 400% larger than the maximum nominal resting diameter of the at least one eccentric abrading head. a guide wire having a maximum diameter less than the diameter of the artery; a flexible elongated, rotatable drive shaft (20; 20A) advanceable over the guide wire, the drive shaft (20; 20A) having a rotational axis; and at least one eccentric abrading head of single-piece unitary prefabricated construction attached to the drive shaft (20; 20A), the abrading head comprising a maximum nominal resting diameter, a geometric center spaced radially from the rotational axis and a center of mass spaced radially from the rotational axis as a consequence of the radial spacing of the geometric center away from the rotational axis, proximal (30; 30A), intermediate (35; 35A) and distal (40; 40A) portions, wherein the proximal portion (30; 30A) comprises a proximal outer surface, the intermediate portion (35; 35A) comprises an intermediate outer surface and the distal portion (40; 40A) comprises a distal outer surface, the proximal outer surface having diameters that increase distally, the distal outer surface having diameters that decrease distally, and the intermediate outer surface being cylindrical, wherein the proximal portion (30; 30A) and the intermediate portion (35; 35A) intersect and define an edge at the intersection between the proximal portion (30; 30A) and the intermediate portion (35; 35A) and wherein the distal portion (40; 40A) and the intermediate portion (35; 35A) intersect and define an edge at the intersection between the distal portion (40; 40A) and the intermediate portion (35; 35A), wherein the eccentric abrading head comprises a nominal diameter and wherein at least the intermediate outer surface comprise a tissue removal section and wherein the abrading head defines a drive shaft lumen therethrough, the drive shaft (20; 20A) at least partially traversing the drive shaft lumen, wherein the portion of the drive shaft (20; 20A) traversing the drive shaft lumen and attaching thereto comprises at least two sections, each section attached to the drive shaft lumen with a gap between the at least two drive shaft sections, and a hollow cavity (25; 25A) comprising a size and shape for customization of the positioning of the center of mass of the at least one eccentric abrading head away from the drive shaft's rotational axis for stimulation of orbital rotational pathing of the at least one eccentric abrading head, wherein the tissue removing section rotates through a path with a maximum rotational diameter that is between about 200% and about 400% larger than the maximum nominal resting diameter of the at least one eccentric abrading head.