A hydrodynamic catheter comprising: a catheter body having a catheter lumen extending along a length of the catheter body from a catheter proximal portion to a catheter distal portion, an infusion tube including an infusion lumen extending along a length of the catheter lumen, the infusion tube extending within the catheter body from the catheter proximal portion towards the catheter distal portion and being configured to deliver fluid under pressure to the catheter distal portion for removal of thrombus, the catheter distal portion including a treatment portion, the treatment portion including at least one inflow orifice and at least one outflow orifice, a pivot cylinder extending through a sidewall of the catheter body and including a pivot cylinder inlet, a pivot cylinder outlet and a guidewire lumen extending therebetween, the pivot cylinder being radially spaced around the catheter body from the at least one inflow orifice and the at least one outflow orifice, wherein the pivot cylinder and the guidewire lumen are eccentric relative to a longitudinal axis of the catheter, and wherein the treatment portion is positioned distal relative to the pivot cylinder, a guidewire positioned through the guidewire lumen and extending along a catheter body external surface at least between the at least one inflow orifice and the at least one outflow orifice, wherein the guidewire extends within the catheter lumen at a position proximal to at least the outlet orifice, and a fluid jet emanator in fluid communication with the infusion tube, wherein the fluid emanator includes one or more jet orifices directed in a proximal direction toward the catheter proximal portion. a catheter body having a catheter lumen extending along a length of the catheter body from a catheter proximal portion to a catheter distal portion, an infusion tube including an infusion lumen extending along a length of the catheter lumen, the infusion tube extending within the catheter body from the catheter proximal portion towards the catheter distal portion and being configured to deliver fluid under pressure to the catheter distal portion for removal of thrombus, the catheter distal portion including a treatment portion, the treatment portion including at least one inflow orifice and at least one outflow orifice, a pivot cylinder extending through a sidewall of the catheter body and including a pivot cylinder inlet, a pivot cylinder outlet and a guidewire lumen extending therebetween, the pivot cylinder being radially spaced around the catheter body from the at least one inflow orifice and the at least one outflow orifice, wherein the pivot cylinder and the guidewire lumen are eccentric relative to a longitudinal axis of the catheter, and wherein the treatment portion is positioned distal relative to the pivot cylinder, a guidewire positioned through the guidewire lumen and extending along a catheter body external surface at least between the at least one inflow orifice and the at least one outflow orifice, wherein the guidewire extends within the catheter lumen at a position proximal to at least the outlet orifice, and a fluid jet emanator in fluid communication with the infusion tube, wherein the fluid emanator includes one or more jet orifices directed in a proximal direction toward the catheter proximal portion.