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.