Provided herein are dual-lumen catheters, systems, and methods thereof. In some embodiments, for example, a catheter assembly configured for modifying intravascular lesions is provided including a core wire, a dual-lumen extrusion including the core wire, and a manifold disposed around a portion of the dual-lumen extrusion. The core wire includes a proximal end configured to vibrationally couple to an ultrasound transducer. The dual-lumen extrusion includes a first lumen and a second lumen. The core wire is disposed within the first lumen, and the second lumen is configured to accommodate a guidewire. The manifold is disposed around at least a skived proximal-end portion of the dual-lumen extrusion, wherein the skived portion includes the second lumen without the first lumen. In some embodiments, the catheter assembly further includes the ultrasound transducer. In some embodiments, a system console includes the ultrasound transducer.