Abstract: A catheter system facilitates blood treatments such as apheresis that require simultaneous withdrawal and return of blood to a patient at high flow rates. A multi lumen catheter has an external coupling device connected to a pump and blood treatment device. All of the lumens are designed to be used in the blood treatment process. The catheter includes two or more lumens for withdrawing blood and a return lumen for returning treated blood. The combined flow resistance of the withdrawal lumens is less than or equal to the flow resistance of the return lumen so that the flow rate of blood through the withdrawal lumens does not require a pressure differential sufficient to collapse the lumens. High flow rates are achievable through the catheter by using a pair of withdrawal lumens instead of a single, large withdrawal lumen. The lumens may be used for general medical use when the catheter system is not being used for exchange treatments.