A system for removing an in-place intravascular device such as a catheter or guidewire from a patient's body lumen such as from a coronary artery and advancing a catheter or other similar device through the vascular system until its distal end is located at a desired location within the vascular system. The system includes an exchange catheter, which may be a dilatation catheter, having a flexible strand forming a loop at the distal end of the catheter which is adapted to be disposed about the guidewire or catheter which is in-place within the patient. The loop is tightened about the elongated intraluminal in-place device to be removed so that the catheter can be advanced over the in-place device until the distal end of the catheter is at a desired location within the patient's vasculature. The catheter may be used to perform a diagnostic or therapeutic procedure such as an angioplasty or a replacement device may be advanced through an inner lumen and out the distal end of the catheter.