The treatment of coronary artery disease has changed significantly over the last decade. It is estimated that more than 300,000 percutaneous transluminal coronary angioplasty procedures were performed in 1990. Despite advances in angioplasty technique and increased immediate success rates, limitations to treatment remain and have prompted a continuing search for a more effective revascularization device. Rotational ablation performed with a high-speed burr covered with diamond microcrystals has been proven safe and effective in treating coronary lesions. At high speeds the burr preferentially ablates plaque. The particles produced during the procedure are smaller than red blood cells and are readily disposed of by the reticuloendothelial system. This article is an overview of the rotational ablation procedure and related nursing care of the patient.