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 is rotatable about the pivot cylinder between at least first and second rotated positions: in the first rotated position the inflow and outflow orifices are directed in a first direction, and in the second rotated position the inflow and outflow orifices 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 is rotatable about the pivot cylinder between at least first and second rotated positions: in the first rotated position the inflow and outflow orifices are directed in a first direction, and in the second rotated position the inflow and outflow orifices are directed in a second direction different from the first direction. in the first rotated position the inflow and outflow orifices are directed in a first direction, and in the second rotated position the inflow and outflow orifices are directed in a second direction different from the first direction. <EOS>