An atherectomy device for reducing stenosis material from a vascular vessel is provided. The atherectomy device includes an elongated flexible tubular member having at least one lumen extending therethrough and having proximal and distal extremities. A flexible drive means disposed within the tubular members is free to move both rotationally and axially therein. A cutting assembly is carried by the distal extremity of the flexible tubular member with a cutter being carried by the distal extremity of the flexible drive means for removing a portion of the stenosis from the vessel wall. An inflatable dilation balloon is carried by the tubular member proximally of the cutter for further reducing the stenosis after initial reduction by the cutter. A perfusion channel maintains blood flow past the dilation balloon. Methods of the present invention include cutting and dilating a stenosis, cutting then immediately dilating a stenosis, and dilating then immediately cutting a stenosis.