An atherectomy and thrombectomy system includes a catheter body extending between proximal and distal catheter portions. The catheter body includes an aspiration lumen extending therein. An atherectomy assembly is coupled with the distal catheter portion and includes a rotatable cutter. A thrombectomy assembly is coupled with the distal catheter portion. The thrombectomy assembly includes a jet body within the aspiration lumen, and inflow and outflow orifices extending through the catheter body and in communication with the aspiration lumen. In a thrombectomy configuration a cyclical flow is generated by the jet body through the outflow and inflow orifices to hydrodynamically abrade thrombus, the cyclical flow entrains thrombus and delivers thrombus into the aspiration lumen. In the atherectomy configuration the rotatable cutter cuts plaque into plaque particulate, and the cyclical flow of the thrombectomy assembly entrains the particulate and delivers the particulate into the aspiration lumen.