Abstract

Esophageal stent insertion has been used as a well-accepted and effective alternative to manage and improve the quality of life for patients diagnosed with esophageal diseases and disorders. Current stents are either permanent or temporary and are fabricated from either metal or plastic. The partially covered self-expanding metal stent (SEMS) has a firm anchoring effect and prevent stent migration, however, the hyperplastic tissue reaction cause stent restenosis and make it difficult to remove. A fully covered SEMS and self-expanding plastic stent (SEPS) reduced reactive hyperplasia but has a high migration rate. The main advantage that polymeric biodegradable stents (BDSs) have over metal or plastic stents is that removal is not require and reduce the need for repeated stent insertion. But the slightly lower radial force of BDS may be its main shortcoming and a post-implant problem. Thus, strengthening support of BDS is a content of the research in the future. BDSs are often temporarily effective in esophageal stricture to relieve dysphagia. In the future, it can be expect that biodegradable drug-eluting stents (DES) will be available to treat benign esophageal stricture, perforations or leaks with additional use as palliative modalities for treating malignant esophageal stricture, as the bridge to surgery or to maintain luminal patency during neoadjuvant chemoradiation.

Highlights

  • Esophageal strictures (ES) are commonly caused by benign and malignant diseases, and according to the method can be divided into operative and non-operative treatment

  • Biodegradable stent (BDS) can be made from different synthetic polymers (PLA and polyglycolic acid (PGA))

  • Further refined the design to PLLA monofilaments in a zigzag helical coil configuration with 0.17mm thick struts. This arrangement resulted in a reduced vascular injury at the implantation site, reduced initial thrombus deposition and cut down neointimal proliferation. Another interesting concept is the design of multi-layered biodegradable stent by Eury et al [28], which is made from variety of polymers such as PLLA, PGA, PCL, poly-orthoesters or poly-anhydrides

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Summary

Introduction

Esophageal strictures (ES) are commonly caused by benign and malignant diseases, and according to the method can be divided into operative and non-operative treatment. Since BDSs do not require endoscopic removal and alleviate dysphagia to dysphagia or SEPS, they areinbeginning to beof used in the benign or or SEPS, they to areSEMS beginning to be used the treatment benign or treatment malignantofesophageal malignant esophageal strictures. SEMS and stent placement is a commonly used, minimally invasive method treat benign or andSEPS stent placement is a commonly used, minimally invasivetomethod to treat malignant esophageal strictures. Due to Due the to limited success of SEMS and benign or malignant esophageal strictures.

Polymeric
Prerequisites for Polymeric Biodegradable Stents
Advantages
Influence
History
Preclinical Studies with Polymeric Biodegradable Stents
Preclinical
Benign
Malignant Stricture
Leaks or Perforations
Diagrammatic
Patient
11. Limitations of therare
Findings
Conclusions
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