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How to untie a transfemoral catheter knot with a transradial Lasso

March 2013 Br J Cardiol 2013;20:38 doi:10.5837/bjc.2013.008

How to untie a transfemoral catheter knot with a transradial Lasso

John Rawlins, Nimit Shah, Suneel Talwar, Peter O’Kane 

Abstract

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

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