Esophageal stents: Indications and placement techniques

Abstract

For over a century, the creation of a new esophageal lumen through an obstruction - either benign or malignant - by the placement of an endoprosthesis has been possible. Though the concept has not changed during that time, the materials used certainly have. The use of catheter-bound, self-expanding metal as well as plastic stents has led to an easier and far safer means of minimally invasive treatments for a variety of conditions within the esophagus. Malignant esophageal obstruction remains, by far, the leading indication for esophageal stent placement; however, other conditions such as tracheoesophageal fistula, refractory benign esophageal strictures, iatrogenic perforation, and anastomotic leaks can also be successfully managed in this fashion. Esophageal stent placement is safe and technically feasible in most patients, and the devices are associated with high rates of initial symptom relief and leak closure. Despite this, the major drawback for these devices remains the high rate of reintervention due to stent occlusion and migration.