A method and system of performing an intravascular procedure at a treatment site in a vessel of a patient. A device creates a seal to prevent the flow of blood during the treatment of vascular disease. A seal may be formed between the distal inside diameter of a sheath or catheter such as a guide catheter as well as within a vessel, such as an artery or vein. An elongated device having a distal portion extending from the catheter and having a fluid impermeable membrane disposed about at least the distal end of the device is used to seal the vessel. The system includes a device to occlude blood flow and a distal protection device to filter or remove embolic debris.