The present embodiments relate to an endovascular treatment system comprising a sheath having a sheath lumen and a sheath aperture located on a circumferential surface of the sheath, and an internal liner disposed at least partially within the sheath lumen. The internal liner comprises a liner aperture, a protrusion, and a liner lumen, and has a delivery state and an expanded state. In the expanded state, the protrusion extends out of the sheath lumen through the sheath aperture.