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Aortic aneurysm is the 13th leading cause of death in the United States. The prevalence of aortic aneurysms appears to be increasing, due in part to a higher level of awareness, advancement in imaging modalities, and an aging population. The incidence of thoracic aortic aneurysms is estimated to be around 10.4 cases per 100,000 person-years. In the future, it is likely that hybrid repair will be replaced by total endovascular techniques in most centers. Future applications may be for patients who are high risk for open TAAA repair, those who fail total endovascular repair or in centers with no access or experience with fenestrated and branched endografts. Keys for successful outcomes include patient selection, case planning, and knowledge of the technical aspects of the procedure.

In this chapter, we will be reviewing complications after TEVAR, including mortality, neurological complications (stroke, spinal cord ischemia), complications related to coverage of subclavian artery, device malfunctioning, endoleak, migration, retrograde dissection, and access complications.

Given their rapidly fatal course, intrathoracic vascular injuries have long captured the interest of surgeons. Over the past two decades, a lot has been done to overcome this infamous clinical course. The ever-evolving technology involving the diagnostic and therapeutic modalities has helped produce a paradigm shift in the approach toward management of these types of injuries. Moreover, this advancement has produced a radical change in the diagnosis and outcome of patients with both blunt and penetrating thoracic injuries.