Systems and methods for controllably traversing a tubular vessel, e.g., of a patients vasculature. In one example, a distal end of a catheter is positioned and/or repositioned utilizing direct visualization out the distal end of the catheter, as facilitated by an imaging element disposed within the distal tip of the catheter. An inflatable balloon may comprise a portion of the distal tip of the catheter for structural and/or visualization media purposes. The balloon may define one or more channels configured to facilitate fluid flow between proximal and distal ends of the balloon after the balloon is inflated within the tubular vessel.
