Balloon catheter (100) includes an outer shaft having a hypotube (220) and a monolithic single-layer distal outer member (230), a balloon (140) in fluid communication with an inflation lumen (200,201,202), and an inner tubular member (240) having a guidewire lumen (210,211) defined therethrough. The outer shaft has the inflation lumen defined therethrough. The monolithic single-layer distal outer member is necked to a reduced diameter along an entire length thereof. A proximal end of the monolithic single-layer distal outer member is coupled to the hypotube. A distal section (222) of the hypotube comprises a skive defined by a first angled cut, an axial cut, and a second angled cut. The balloon has a proximal balloon shaft (145) coupled to a distal end of the monolithic single-layer distal outer member. The inner tubular member extends distally from a proximal port (210) in the monolithic single-layer distal outer member through at least a portion of the balloon.