First line of defense is obviously the spare tire. Today's space saving, high-pressure "convenience" spare or donut can run from 3,000 to 5,000 miles, depending on ply type, with decent handling. But, after sitting in the trunk for years, is your spare properly inflated to 60 psi to meet the call? Probably not.
Sealant tires were invented before the turn of the current century, but they only work if the puncture is in the tread area and under 1/4-inch in diameter. But even if effective, future tire failure may be masked. Without periodic inspection, any object puncturing the tread can work loose, just moving the spare-tire option down the road.
Popular with late-night TV addicts is the tire inflator or "spare in a can." But to be useful the liquid must coat the entire inside of the tire--leaving a mess for the repairman. And water-based sealants may degrade tire material.
Custom wheels and tire inserts are the high-cost alternatives. Special wheels were developed 10 to 20 years ago to keep tires seated on the rim. A tire insert is a "tire within a tire," such as the Goodyear Lifeguard, a version of which is used for NASCAR racing.Tire inserts have also been made of metal or fiberglass for low-speed, heavy-load applications such as military vehicles and presidential limousines.