It is estimated that the prevalence of cardiovascular diseases has reached 330 million people in China,with approximately 11.39 million coronary artery disease patients and 45.3 million peripheral arterial disease patients.The potential market for medical devices related to the treatment of cardiovascular disease and peripheral arterial disease is relatively large.Percutaneous arterial intervention has become the most common treatment method for coronary artery and lower limb arterial diseases.However,this approach still faces significant challenges when dealing with complex lesions such as high-resistance lesions.Intravascular laser atherectomy,with its precise capability to remove or alter lesioned tissue,has shown unique advantages in treating complex arterial lesions.This article comprehensively reviews the mechanisms of action of laser atherectomy and the major intravascular laser atherectomy systems on the global market,with a detailed discussion of the technical parameters of the related products.Moreover,the article compares different systems in terms of photochemical,photothermal,and photomechanical effects,clearly identifying key differences between the technologies and their clinical applications.