Balloon-Assisted and Snare-Facilitated Retrieval of a Kinked Radial Catheter Entrapped in the Axillary Artery

BACKGROUND: Catheter kinking during transradial coronary angiography is rare but may result in fixed entrapment, where forceful manipulation risks vascular injury. CASE SUMMARY: A 67-year-old woman with non-ST-segment elevation myocardial infarction underwent diagnostic coronary angiography via right radial access using a 6-F FL3.5 catheter. During manipulation, the catheter became fixed and kinked in the axillary artery, with loss of rotational control. Standard wire-based maneuvers failed. Dual arterial access was obtained with femoral snare stabilization of the distal catheter tip and intraluminal low-pressure balloon inflation to straighten the kink, allowing telescoping guide catheter advancement and controlled retrieval. Final angiography showed no vascular injury. The thrombotic culprit lesion was treated with aspiration thrombectomy and balloon angioplasty. DISCUSSION: This case demonstrates stepwise application of a bailout technique to manage complex radial catheter entrapment. TAKE-HOME MESSAGE: Early recognition and controlled escalation using dual access and intraluminal support can enable safe catheter retrieval without treatment delays.