Preventing Kinks and Entrapments in Coronary Interventions With Innovative Approaches

To describe a novel balloon-assisted intraluminal technique for the removal of a kinked catheter during transradial coronary angiography complicated by subclavian artery tortuosity. Catheter kinking was recognized during transradial access, refractory to standard maneuvers. A retrieval attempt with snare via femoral access failed. Using multiangle fluoroscopy, a 0.014-inch BMW guide wire (Abbott) was advanced through the kinked catheter lumen. Inflation of a 2.0-mm low-profile balloon within the kinked segment provided intraluminal support. Slow inflation of the balloon allowed controlled traction and smooth catheter removal without adverse effects. Vessel damage or catheter breakage may occur if aggressive manipulation is attempted without intraluminal support. Precise fluoroscopic documentation of wire placement is essential. Operator expertise is paramount; escalation from simple to complex techniques should be followed. Attention to patient selection, catheter choice, and real-time imaging reduces risk. Proper catheter handling, minimized manipulation, and device selection are crucial. Operator expertise ensures safe, efficient outcomes.