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Knotting of a coronary catheter during cardiac catheterization is a relatively common event and can usually be resolved by simply untwisting the catheter or by straightening it with a guidewire. If these manoeuvres fail, the knotted catheter may be retrieved using a snare device; however, if unsuccessful, surgical extraction may prove necessary. The authors describe a case in which a snare device failed to retrieve a knotted catheter firmly impacted within a loop in the external iliac artery. The catheter was successfully mobilized using an angioplasty balloon inflated distal to the site of impaction then pulled back, allowing dislodgement of the knot and subsequent extraction of the catheter from the contralateral femoral artery.