A previous healthy, 17-year-old male with gigantic congenital venous malformation on the right thigh, was scheduled to undergo his first ethanol embolotherapy under general anesthesia. Ethanol embolization was performed successfully without any event during the session. Three minutes after the extubation in the postanesthetic unit, the saturation of peripheral oxygenation suddenly fell steeply and asystole has been developed. Cardiac resuscitation was initiated according to the Advanced Cardiac Life Support protocol. Fifty minutes after initiation of cardiac resuscitation, ventricular fibrillation was emerged from asystole. After defibrillation, arrhythmic sinus-origined cardiac rhythm was developed. On the next day, the electroencephalography showed broad severe brain damage. Anes-thesiologist should keep in mind that, residual effect of absolute ethanol can significantly affect the patient during the period of emergence from the ethanol embolotherapy. Careful management, including delayed extubation and close monitoring, should be applied to the patients who underwent ethanol embolotherapy during the recovery period. (J Acute Care Surg 2013;3:60-62)
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