Although the fundamentals of Endovascular Surgery were set down over 30 years ago, only recently has the potential impact of this therapy become readily apparent. Endovascular therapies with new instrumentation for the treatment of arterial aneurysms, occlusions, trauma, and venous thrombotic disorders have progressed dramatically over the past 5 years. Guidewire and catheter techniques for endovascular instrumentation of vessels have also been shown to compliment standard vascular surgical interventions. The need for vascular surgeons to obtain the knowledge and professional skills to perform wire and catheter techniques is essential to convert the professional "threat" of endovascular surgery to a future of "opportunity."