The invention provides devices and methods for crossing total chronic occlusions. In certain aspects, a device for imaging a vessel includes an elongate body defining a first lumen and comprising a distal end a housing operably associated with the distal end and comprising a forward-looking imaging element and a member at least partially disposed within the first lumen of the elongate body the member configured to extend beyond the distal end of the elongate body to advance into an occluded vessel.
