Excimer laser coronary atherectomy (ELCA) is utilized as adjunctive therapy in percutaneous coronary intervention (PCI) for moderately calcified lesions, chronic total occlusions, in-stent restenosis, under-expanded stents, and balloon-uncrossable lesions. We interrogated the post-marketing surveillance data from the U.S. Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database to evaluate the complications associated with ELCA use [1].