A hybrid liquid-jet/laser device may be used to remove material from a tube or sheet to form a medical device, such as a stent. The liquid-jet/laser stream may be impinged against the wall of the tube or sheet between the ends of the tube or sheet, wherein an aperture may be formed in the tube or sheet, followed by a lead-in, and then a full thickness cut. A full thickness cut should be achieved via a lead-in before moving the liquid-jet/laser stream along a final cut path.