facilitated by deflecting the cutting wheel 106 so that it protrudes slightly through the window 107 this way the exposed tip of the cutting wheel may freely shave away stiff regions of exposed plaque that might not otherwise bend to extend inside the catheter window this deflection may be achieved by a cam mechanism not shown cam mechanisms of this type were previously taught by application ser nos 10 896 741 10 288 559 10 027 418 the contents of which are incorporated herein by reference the rotating cutting wheel may have sharp edges composed of tungsten carbide and the like in other configurations a wheel need not be used and instead an alternate cutting device such as laser radio frequency electrodes ultrasonic vibrating knifes may be used in still other configurations a cutting wheel can have its cutting effectiveness enhanced by coupling its rotary cutting action with laser radio frequency electrodes ultrasonic vibration and the like as needed device dimensions typically the catheter cutting head 201 will have a diameter between about 1 to 2 2 millimeters the cutting window 107 will typically have a length of about 1 2 to 2 5 millimeters in embodiments where the cutting wheel contains a cam or other orientation control mechanism that allows the wheel to extend slightly outside the window the wheel orientation control mechanism may allow the wheel to at least temporarily be locked into a position that allows the cutting outer edge of the wheel to extend about.