Gentle application of counter-rotational torque may permit guidewire passage to release the knot, but usually distal catheter fixation is required. Previous reports describe ‘grabbing forceps’ or snare delivery from the contra-lateral femoral approach.1,2
We present three transfemoral CA cases, complicated by catheter knotting resolved using transradial snare delivery for distal fixation (figure 1).
Figure 1. Angiographic images demonstrating a series of irreducible knotted catheters (panels Ai, Bi, Ci; white arrows), with distal catheter capture using a gooseneck snare (panels Aii, Bii, Cii) allowing catheter fixation, knot reduction (pa
