Student Presenter(s): Michael Gao
Faculty Mentor: Greg Saggio
School/College: Osteopathic Medicine, Old Westbury

Anesthetic management of a ruptured AAA requires the availability of typed and crossmatched blood products as well as adequate intravenous access, preferably large bore central venous access. EVAR is the preferred method of treating a ruptured AAA as it allows for less blood loss, decreased risk of infection, and a lower mortality rate likely associated with the avoidance of intrathoracic and abdominal exposure. Endovascular access to the aneurysm allows for local, regional, and neuraxial anesthesia to be used in order to avoid GETA and the associated myocardial depression. However, GETA minimizes patient discomfort, and provides immobilization, analgesia, and apnea during stent deployment. Vasodilators or transcutaneous pacing can be used during stent deployment to lower the mean arterial pressure and mitigate the risk of stent migration. Permissive hypotension during this period should be balanced with adequate renal and cerebral perfusion.