An intravascular access system for facilitation of intraluminal medical procedures within the neurovasculature through an access sheath. The system includes an aspiration or support catheter (1320) having a flexible, distal luminal portion (1322) having an inner diameter defining a lumen (1323) extending between a proximal opening at a proximal end of the luminal portion and a distal opening at a distal end of the luminal portion. The catheter has a rigid spine (1330) coupled to at least the proximal end of the luminal portion and extending proximally therefrom. The system includes a dilator (1340) having a flexible, distal dilator portion (1360) sized to be received within the lumen (1323) of the luminal portion (1322). Associated systems, devices, and methods of use are also described.