A balloon catheter includes a balloon having a plurality of layers. The inner layer acts as a support layer to the outer layer. Embedded within the outer layer is a plurality of particles or pellets which in one embodiment provide roughening of the outer surface of the balloon. The particles or pellets, particularly in conjunction with an inner support layer, ensure maintenance of the roughened outer surface of the balloon during inflation of the balloon. In another embodiment, the particles or pellets may be radiopaque and/or echogenic with or without creating surface roughening of the balloon.