Failure modes of thoracic endografts: Prevention and management

Failure modes of thoracic endografts can be broadly categorized as those that typically occur early in the perioperative period and those that occur during late follow-up. In the former category, failures principally involve delivery, deployment, and conformation to the local anatomy. In the postoperative period, failures can manifest as endograft collapse, component separations, and metallic fractures and fabric tears. Some of these events are preventable with careful case selection, planning, and procedural technique, but others require active management with advanced endovascular or surgical adjuncts. No endograft system is immune from these problems. Endograft failure is an equal-opportunity hazard, which underscores the absolute need for diligent, long-term follow-up.