May 2026, Volume 4, Issue 5

Author

Jeenu D, Rahavi R, Meenu Anna John, Nitish Vijayanand, Kirubakaran Davis and Sathish Kumar Dharmalingam

Abstract

A ruptured aortic aneurysm is an ASA physical class 5 emergency associated with high perioperative morbidity and mortality, necessitating rapid multidisciplinary decision-making and intervention. The ruptured aortic aneurysm cases must be centralized to high-volume centers capable of performing both open and endovascular repair to minimize morbidity and mortality. During intervention, the priorities include goal-directed fluid resuscitation, implementing permissive hypotension without compromising end-organ perfusion, and managing massive transfusion while counteracting the lethal triad of acidosis, hypothermia, and coagulopathy. Based on the patient's status and procedural management, anesthesia will be tailored to general or local/monitored anesthesia. This case series highlights outcomes and discharge dispositions of various procedural interventions for ruptured aortic aneurysms.