Esophageal stents: past, present, and future

Esophageal stents have evolved in stages over the years. First introduced over 120 years ago, they were used uncommonly until the Celestin tube in the 1970s, which initiated the era of rigid prosthesis use for the next 20 years. These tubes were fraught with high complication rates, leading to their evolutionary demise and ushering in the current era of self-expanding stents. The latter began as metal (stainless steel followed by nitinol) and have now come to include plastic and biodegradable materials. There are many choices of different types of stents and sizes, with fierce competition among manufacturers. However, several limiting factors remain with current stent technology and the body's response to them. The ideal stent remains elusive. Future needs include focusing on reducing complication rates, which could be done by improving stent design, using different materials/coverings, or creating hybrid stents. In the future, stents could also do more than just pry open a stricture or cover a defect in the esophageal lumen; a possibility includes drug delivery and proving local therapy. The ultimate goal of the esophageal stent of the future would be to treat the underlying condition and restore esophageal function to near normal.