The invention relates to a catheter device and method of use for exchanging a catheter having a full-length guidewire lumen over a conventional-length guidewire without the use of a guidewire extension or an exchange wire. The catheter device includes an elongated shaft defining an inflation lumen and a guidewire lumen extending longitudinally throughout its length, and a hydraulic exchange lumen extending from the proximal end of the shaft and terminating proximal the distal end of the shaft, wherein the hydraulic exchange lumen is in fluid communication with the guidewire lumen. A balloon is coupled to the distal section of the shaft and is in fluid communication with the inflation lumen. A flow guiding member is disposed within the guiding catheter and functions to redirect the distal flow of pressurized fluid traveling through the hydraulic exchange lumen in a proximal direction through the guidewire lumen.