Last year was eventful in the vascular and endovascular world. Regulatory approval (in the United States) of carotid stenting and thoracic aortic endografting was — clearly — among the most salient developments. Their likely enormous impact is only beginning to be felt. Rapid expansion and further refinements in both fields are sure to take place in the new year and beyond. Technological innovation in a number of areas will continue to occupy most of our attention in 2006. There are many exciting areas that will undoubtedly capture headlines in the near future, such as nano-technology, vascular imaging and bio-absorbable stents, to name a few. The re-birth of atherectomy has been another noteworthy development. Time, (but mostly, convincing evidence), will tell whether this technology is here to stay… this time around. While trying to avoid speaking of a “downside,” we must also recognize the enormous challenges that lie ahead. Health economics and “who’s going to pay for all this?” are rapidly ascending to the very top of this list — and are likely to remain there for years to come. On the technology/cognition side, the conquest of restenosis remains (almost) totally elusive. Effective and durable endovascular treatment of advanced disease in the superficial femoral artery and beyond continues to stand tall as an unresolved and somewhat confusing (or poorly understood) area for technology and interventional practice. At Vascular Disease Management, we feel good about recent accomplishments, but at the same time, recognize that 2005 represented perhaps nothing but baby steps in a likely long and bumpy road to the ultimate goal of becoming a major partner and support for all practicing vascular specialists, representing various training backgrounds or specialty labels. We feel we are on the right path, but, as always, need the readers’ critical input to right what may be wrong and optimize what may be inadequate. Won’t you help us? An occasional word of praise will be welcome as well… Happy New Year!