Background: Complications caused by transluminally-placed endovascular prosthetic grafts (TPEGs) can be fatal in high-risk patients. Case: An 82-year-old man with chronic renal failure, coronary artery disease, carotid/cervical artery disease and bladder cancer (postoperative state) complicated with a descending aortic aneurysm received a TPEG. Results: The abdominal aorta and external iliac artery were damaged when the delivery sheath was removed. An aortic occlusion balloon was immediately applied and emergency surgical laparotomy was performed. The abdominal aorta was ruptured and the intima of external iliac artery was totally skeletonized from the adventitia. Graft replacement of the abdominal aorta and right external iliac artery resulted in rescue of the patient. Conclusion: The possibility of fatal complications of TPEGs requires careful consideration.