OBJECTIVE To describe a new alternative technique for treating coronary artery disease: the coronary atherectomy with the transluminal endarterectomy-extraction catheter. METHODS Four patients, 1 female and 3 males age 46 to 65 years (mean 53 +/- 8.5 years), were submitted to coronary atherectomy with the transluminal endarterectomy-extraction catheter. One patient presenting stable angina, one presenting recent angina, one with residual stenosis after acute myocardial infarction treated with intravenous streptokinase and one with two episodes of syncope and ECG alterations. The treated arteries were: left anterior descending in 3 patients and left circumflex in one. Two lesion were concentric and two were segmentary and eccentric. RESULTS The coronary artery stenosis ranged from 80 to 95% (mean of 90 +/- 7.1%) before the atherectomy and from 20-50% (mean of 32.5 +/- 12.6%) after the atherectomy. Except the first patient, the other 3 were discharged in less than 48 hours after the atherectomy. None presented chest pain during the procedure and in three of them were no recordings of dissection or coronary artery perforation. In one patient the treated artery presented total occlusion (thrombus) 15 minutes after the procedure, but was immediate and successfully reopened with balloon angioplasty. CONCLUSIONS Coronary atherectomy with the "transluminal endarterectomy-extraction catheter" has shown to be a safe and feasible procedure and to bring satisfactory immediate results.