Abstract: Intralumenal material removal systems are provided using an advanceable and rotatable cutter assembly designed for differential cutting. The intralumenal material removal system includes a cutter assembly positionable in the body cavity of a mammalian subject. One embodiment of the cutter assembly includes a cutter with blades that are designed and arranged to form an acute blade angle of attack with the matter-to-be-removed. The cutter assembly is axially advanceable by translating the drive shaft and rotatable by rotating the drive shaft. The occlusive material is scraped by the cutter assembly and may be aspirated to remove the material from the body cavity. The cutter assembly may provide aspiration ports positioned between facing surfaces of the blades.