A dual guidewire exchange catheter system and methods are provided herein. The dual guidewire exchange catheter system includes two lumens for receiving therethrough a main vessel guidewire and a branch vessel guidewire, respectively. The catheter includes an exit port for each guidewire, at least one of which is a shorter distance from the distal end of the catheter system than the distance from the distal end to the proximal end of the catheter. This allows for management of relatively short guidewire lengths outside the body.
