Severe catheter kinking and entrapment during transbrachial angiography: percutaneous retrieval with a slender approach.

A 74-year-old man previously treated with bilateral femoro-popliteal bypass was referred to our hospital for the treatment of a severely tangled 4-Fr diagnostic catheter in the right brachial artery. We inserted a 5-Fr sheath introducer from the proximal right femoral artery and advanced a 5-Fr JR catheter to the right brachial artery. A Sion coronary guidewire was then advanced for the tip of the tangled catheter, and a 4-mm gooseneck snare catheter was inserted through the guidewire. The tip of the catheter was caught and successfully removed after clockwise untwisting. The patient was discharged the next day without any complications.