Biodegradable esophageal polymeric stents: innovations, challenges, and clinical applications

Biodegradable esophageal stents are a family of promising biomedical products designed to address esophageal disorders such as strictures, fistulas, and cancer-related blockages. Unlike non-biodegradable stents, these devices provide temporary luminal support and subsequently undergo controlled hydrolytic or enzymatic degradation that produce non-toxic metabolites such as lactic acid and caproic acid that can be assimilated into normal metabolic pathways. Made from biocompatible polymers such as PLA and PCL, their degradation kinetics, crystallinity, and mechanical integrity are directly linked to polymer stereochemistry, molecular weight, and processing method, offering a mechanistic basis for tuning stent performance. Biodegradable stents eliminate the need for surgical removal while providing transient support. In this review, the factors influencing in vivo polymer degradation, including polymer composition, physicochemical properties, and material design considerations, are discussed. Traditional metal and plastic stents are also compared with biodegradable stents in terms of structure, function, and molecular-level determinants of clinical efficacy. Emerging fabrication strategies such as 3D printing are discussed in the context of how they modulate degradation pathways, mechanical resilience, and host tissue response. Finally, future research directions are proposed to optimize degradation profiles, enhance biocompatibility, improve mechanical performance, and enable personalized stent designs through advances in polymer chemistry and fabrication technologies. Accordingly, continued interdisciplinary innovation can lead to obtaining biodegradable polymeric stents that have the potential not only to reduce clinical complications and enhance patients’ quality of life but also to provide mechanistic insights into material–tissue interactions and controlled biomaterial degradation in clinical settings.