Over the time as calcium builds up in the artery walls, plaque can become extremely rigid and hard for an angioplasty balloon to stretch the artery open. Here comes the role of the rotablator, a small drill with a burr on the end that is coated in diamond dust. The rotablator is used in a type of catheter-based procedure called rotational atherectomy. The rotablator drills through the calcified plaque, breaking up the plaque into tiny pieces as it works. These pieces of plaque are small enough to be safely picked up by bloodstream and eventually the body eliminates them. Following rotablation stent expansion is optimal.