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A 28-year-old male with history of vascular Ehlers-Danlos syndrome (VEDS) presented with left lower extremity acute limb ischemia. Computed tomography angiography demonstrated spontaneous dissection of the left common iliac artery with occlusion and associated contained rupture . Successful stent placement without associated complications was achieved with the following principles: (1) open arterial exposure for endovascular intervention; (2) no touch technique vessel dissection; (3) circumferential proximal arterial felt cuff reinforcement to reduce systolic pulse wave stretch on sutures, and in case of emergent ligation; and (4) pledgetted “preclose U” stitch monofilament suture prior to access.