Hemodynamic Instability After Endovascular AAA Repair: A Case Report
American Society of Anesthesiologists, The Anesthesiology Meeting, October 10-14, 2025, San Antonio, TX
Abstract
A patient with a ruptured abdominal aortic aneurysm underwent thoracic endovascular aortic repair and was admitted to the surgical ICU postoperatively in critical condition. He remained hemodynamically unstable despite maximal support. Ongoing instability raised concern for intra-abdominal hemorrhage and abdominal compartment syndrome. An emergent bedside laparotomy was performed. Intraoperatively, active intra-abdominal bleeding was identified and hemostasis achieved. Shortly thereafter, the patient developed acute hypoxia and signs consistent with transfusion-related acute lung injury (TRALI). Despite continued resuscitative efforts, the patient progressed to asystole. This case illustrates the complexity of postoperative management and complications following endovascular repair of ruptured aortic aneurysms.