An 82-year old male was referred with dyspnea and fever after a
Staphylococcus aureus bacteraemia. The CTA scan showed a mycotic
aneurysm of the descending thoracic aorta with impending rupture.
Antibiotic treatment was started and endovascular aorta repair
performed. Postoperatively, patient deteriorated as result of severe
tracheal compression due to progressive dilatation of the aneurysm
caused by a suspected type I endoleak. A tracheal stent was placed and
the endovascular stent graft extended. Despite decreased ventilation
pressure patient died of respiratory insufficiency. Even though,
antibiotic treatment and endovascular stent grafting have improved
outcome of mycotic aneurysms, severe complications following
unsuccessful endovascular stent grafting do occur and can be lethal.