A hydrodynamic catheter comprising: a catheter body with a catheter lumen extending from a proximal catheter portion to a distal catheter portion; an infusion tube extending within the catheter body from the catheter proximal portion toward the catheter distal portion, the infusion tube is configured for coupling with a fluid source near the catheter proximal portion; an inflow orifice at a first location along a catheter body perimeter; an outflow orifice at a second location along the catheter body perimeter spaced from the first location; a fluid jet emanator in fluid communication with the infusion tube, the fluid jet emanator including one or more jet orifices, the one or more jet orifices configured to direct one or more fluid jets through the catheter lumen from near the inflow orifice toward the outflow orifice; and a pivot cylinder including a pivot cylinder inlet, a pivot cylinder outlet and a guidewire lumen extending therein, the pivot cylinder being distal relative to the fluid jet emanator, the inflow orifice and the outflow orifice, wherein the pivot cylinder inlet is radially spaced around the catheter body from the inflow orifice and the outflow orifice, wherein the pivot cylinder outlet is in a non-parallel orientation to the pivot cylinder inlet; and wherein the pivot cylinder outlet is located distally relative to the pivot cylinder inlet; and wherein a treatment portion of the catheter body including the inflow and outflow orifices (26, 28) is rotatable about the pivot cylinder between at least first and second rotated positions: in the first rotated position the inflow and outflow orifices (26, 28) are directed in a first direction, and in the second rotated position the inflow and outflow orifices (26, 28) are directed in a second direction different from the first direction. a catheter body with a catheter lumen extending from a proximal catheter portion to a distal catheter portion; an infusion tube extending within the catheter body from the catheter proximal portion toward the catheter distal portion, the infusion tube is configured for coupling with a fluid source near the catheter proximal portion; an inflow orifice at a first location along a catheter body perimeter; an outflow orifice at a second location along the catheter body perimeter spaced from the first location; a fluid jet emanator in fluid communication with the infusion tube, the fluid jet emanator including one or more jet orifices, the one or more jet orifices configured to direct one or more fluid jets through the catheter lumen from near the inflow orifice toward the outflow orifice; and a pivot cylinder including a pivot cylinder inlet, a pivot cylinder outlet and a guidewire lumen extending therein, the pivot cylinder being distal relative to the fluid jet emanator, the inflow orifice and the outflow orifice, wherein the pivot cylinder inlet is radially spaced around the catheter body from the inflow orifice and the outflow orifice, wherein the pivot cylinder outlet is in a non-parallel orientation to the pivot cylinder inlet; and wherein the pivot cylinder outlet is located distally relative to the pivot cylinder inlet; and wherein a treatment portion of the catheter body including the inflow and outflow orifices (26, 28) is rotatable about the pivot cylinder between at least first and second rotated positions: in the first rotated position the inflow and outflow orifices (26, 28) are directed in a first direction, and in the second rotated position the inflow and outflow orifices (26, 28) are directed in a second direction different from the first direction. in the first rotated position the inflow and outflow orifices (26, 28) are directed in a first direction, and in the second rotated position the inflow and outflow orifices (26, 28) are directed in a second direction different from the first direction.