A procedural sheath and methods of use that assists in maintaining a fluid path while the procedural sheath is positioned within a vascular conduit of a patient. The procedural sheath includes one or more channels extending longitudinally along a working length of the body of the sheath. Each channel includes one or more fluid paths configured to allow blood to flow from the vascular conduit into a device receiving lumen of the sheath. One or more elongate members selectively coupled to the body operatively cooperate with the channels to fluidly control fluid access into the device receiving lumen through the fluid paths.
