I have a vintage lathe that needs to have the cross slide
thrust bearing shimmed. I'm not 100% certain, still need
to get more light on the subject and blow the hole out with
air, but I think the handle might be mounted with a blind
roll pin.

OD-

Please forgive my ignorance, but what is a blind roll pin? How was it
installed? Can it come out the way it went in?

If it is one that can be accessed from one end only, then you should be able to
screw something into it that will grip it. Perhaps tapping it would allow a
screw to be inserted, that can then be pulled out.

Fred