A patient developed severe hemodynamic compromise after saphenous vein graft rupture during high-pressure coronary stent deployment. Immediate balloon inflation followed by implantation of a polytetrafluoroethylene-covered stent solved the problem. The next day, follow-up angiography confirmed persistent sealing of the rupture site. Clinical and angiographic features of vessel rupture during coronary angioplasty as well as several therapeutic options for this complication are discussed.