Isolated aortic aneurysms in Takayasu arteritis (TA) are rare. Reported operative mortality and operative complication rates seem low, with an infrequent need for surgical revision, even though most reports concern occlusive disease. Treatment of aneurysms in TA requires therapeutic strategies that are different from the ones used for atherosclerotic vessel dilatations because the pathology and the extensive, progressive, relapsing nature of the disease are deeply different from the atherosclerotic process. We report a case of thoracic stent-graft bulging rupture, a device previously implanted to exclude a thoracic aneurysm, associated with two small aneurysms near the distal implantation site. Both were treated with three new-generation stent grafts implanted in a telescope fashion.