Vascular surgery has seen a remarkable evolution. A discipline focused on the natural history and treatment of vascular disease by open operation is now primarily a minimally invasive specialty. Mastery of the basic pathophysiology has been retained while the transformation by improved imaging and endovascular intervention has been integrated into practice. This fourth edition of Vascular Surgery: Principles and Practice has incorporated these advances building on the specialty's past assets. Knowledge of natural history and open surgery will always have an essential role in optimal care of patients with vascular diseases. The authors' exposition of the old and the new will make this edition a valuable resource for vascular surgeons and all others dedicated to the care of vascular patients.