Balloon-Assisted Untwisting Technique

Many operators prefer the right radial approach due to its straightforward setup for access. However, the right radial approach can present technical challenges because of the tortuosity of the right subclavian artery when compared to the left radial approach. Several cases have been reported involving the kinking or twisting of radial catheters, leading to the catheter becoming trapped in the radial artery.

We present a case of an uncommon instance of a catheter being twist and entrapped in the brachial artery and its successful retrieval using a balloon entrapment technique.

For managing a twisted catheter, a stepwise approach should be followed using the well-known techniques (negotiation with a stiff wire, gentle detwisting and mother-in-child). We add a novel technique to that approach in which a balloon is inflated fixing one end of the catheter while gently exerting traction on the other end to untwist the kink.

Our case describes a new technique, which we named ballon-assisted untwisting technique, for managing catheter kinking during percutaneous coronary procedures.