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The foreign body was successfully removed via open surgical exploration under tourniquet control, with intraoperative ultrasound confirming complete retrieval and identifying a minor mural thrombus. The patient made an uncomplicated recovery with preserved arterial patency on follow-up. This case highlights the diagnostic challenges of organic, radiolucent-retained foreign bodies emphasising the selection of appropriate imaging. It also discussed operative strategies and postoperative management with follow-up in seemingly minor penetrating extremity injuries.<\/jats:p>","DOI":"10.1136\/bcr-2026-272160","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:40:35Z","timestamp":1790239235000},"page":"e272160","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Radial artery penetrating injury with a retained agave spine: diagnostic and surgical considerations"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3896-5057","authenticated-orcid":false,"given":"Cheuk Shan","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Surgery, The University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram","family":"Iyer","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Western Health, Footscray, Victoria, Australia"},{"name":"Department of Vascular Surgery, Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8536-4035","authenticated-orcid":false,"given":"Anantha","family":"Narayanan","sequence":"additional","affiliation":[{"name":"Department of Surgery and Anaesthesia, University of Otago Wellington, Wellington, New Zealand"},{"name":"Wellington Hospital, Wellington, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"2026092401401046000_19.9.e272160.1","doi-asserted-by":"crossref","first-page":"S45","DOI":"10.1055\/s-0038-1676871","article-title":"Intra-arterial Foreign Body following Radial Artery Cannulation Requiring Microsurgical Removal: Case Report and Review of the Literature","volume":"12","author":"Feinstein","year":"2020","journal-title":"J Hand Microsurg"},{"key":"2026092401401046000_19.9.e272160.2","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1177\/11297298251315986","article-title":"Retained foreign body in radial artery: Endovascular retrieval and salvage of a hemodialysis arteriovenous fistula","volume":"27","author":"Choon Kwang Adrian","year":"2026","journal-title":"J Vasc Access"},{"key":"2026092401401046000_19.9.e272160.3","doi-asserted-by":"crossref","unstructured":"Boll JM , Dennis AJ , Gwinn E . 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