Of all the developing fields of surgery, few have had the impact of vascular surgery in affecting so large a segment of the population with its potential for relief of disability or the prolongation of life. As would be anticipated, the interest of surgeons in this evolving specialty has been largely focused upon the selection of the most appropriate operations and the development of modifications or new procedures to overcome the limitations of previous ones. The literature contains numerous conflicting claims on the relative merits of various procedures. Those approaching this field for the first time may understandably be confused. Yet, if one were to approach any single vascular surgeon at any given time, he would, upon request, receive a firm and precise listing of preferred procedures. The procedures described in this two-volume publication are those which we currently favor. Their selection is the result of continuing anal­ ysis of our own experience of the last 25 years. All patients have been available for prolonged follow-up evaluation. Late failures often identified techniques that lessened the durability of initially satisfactory operations and stimulated the development of modifications or trials with alternate op­ erations. Particular attention is directed here to the manner in which knowledge of the natural history of disease influences the choice of opera­ tion.