Bilateral anterior tibial artery pseudoaneurysms triggered by minor blunt trauma as the initial presentation of vascular Ehlers-Danlos syndrome with a whole-exon deletion

Bilateral lower-limb arterial lesions after minor trauma are rare and suggestive of vascular Ehlers-Danlos syndrome (vEDS). A 40-year-old man developed bilateral anterior tibial artery pseudoaneurysms after being kicked. The right limb, complicated by compartment syndrome, was treated by anterior tibial artery ligation with aneurysm incision and hematoma evacuation; the left, by coil embolization. COL3A1 sequencing was negative, but multiplex ligation-dependent probe amplification revealed a monoallelic whole-exon deletion, confirming vEDS. Hybrid management is safe in vEDS, and copy-number analysis is essential when sequencing is negative, but suspicion persists.