The document discusses different methods for removing plaque from arteries, including atherectomy. Surgical endarterectomy is an invasive approach that led to the development of less invasive atherectomy techniques like laser atherectomy and remote endarterectomy. Excisional atherectomy uses devices like the Silverhawk to remove plaque but can send debris downstream and have high recurrence rates. The goal is to find more effective mechanical and biological plaque removal and prevention methods.