A guiding catheter to facilitate accurate stent length determination

Endoscopic stenting is widely used for drainage in benign and malignant strictures of the bile and pancreatic ducts. Accurate fitting of the stent to the anatomic ductal features is essential, although this is often done by visual assessment alone.

A new guiding catheter, the measuring-mounting catheter, with radiopaque bands at 1 cm intervals from its distal end, was used in 10 patients. Visual estimates, based on fluoroscopic images, of the length of the duct segments considered for stenting were compared with measurements obtained with the catheter.

There was a significant difference between duct length estimations based on visual assessment and lengths determined objectively using the catheter (mean +/- SD, 17 +/- 11 mm; p < 0.0005). In one half of the cases, the operator rejected the stent he chose before using the catheter.

The measuring-mounting catheter improves the precision of plastic stent implantation without loss of time during the procedure. It is particularly useful in technically difficult situations such as hilar or main pancreatic duct strictures.