Management of carotid and vertebral artery disease has undergone tremendous strides since the introduction of thin section CT angiography and neurointerventions. These minimally invasive techniques continue to evolve allowing great advantages for patients. In this book we will focus on both endovascular (minimally invasive) and open arterial reconstructions as both types of procedures are still very much part of routine practice in managing extracranial carotid and vertebral artery disease.