A GUIDING CATHETER TO FACILITATE ACCURATE STENT LENGTH DETERMINATION

Background: Endoscopic stenting is widely used for drainage in benign and malignant strictures of the bile and pancreatic ducts. Accurate fi tting of the stent to the anatomic ductal features is essential, altho ugh this is often done by visual assessment alone. Methods: A new guid ing catheter, the measuring-mounting catheter, with radiopaque bands a t 1 cm intervals from its distal end, was used in 10 patients. Visual estimates, based on fluoroscopic images, of the length of the duct seg ments considered for stenting were compared with measurements obtained with the catheter. Results: There was a significant difference betwee n duct length estimations based on visual assessment and lengths deter mined objectively using the catheter (mean +/- SD, 17 +/- 11 mm; p < 0 .0005). In one half of the cases, the operator rejected the stent he c hose before using the catheter. Conclusions: The measuring-mounting ca theter improves the precision of plastic stent implantation without lo ss of time during the procedure. It is particularly useful in technica lly difficult situations such as hilar or main pancreatic duct strictu res.