This textbook from the European Vascular Course represents the current carotid database analyzed from a primarily European viewpoint. There is no other area in vascular surgery (or perhaps medicine) in which a huge volume of collected data is subjected to a wider degree of interpretation. Percent degrees of carotid stenoses, measured by different modalities interpreted with different techniques, can markedly alter the statistical benefit of operative therapy. In addition, the specific endpoints assessed (transient ischemic attacks, completed, stroke, death), the amount of resources spent in their determination (the operating surgeon's clinical examination, independent neurologist examination, computed tomography), and the details of the intervention (surgeon experience, patch closure, intraoperative monitoring) have been discussed and argued in multiple journals. Does this text offer any useful assistance to the practicing vascular surgeon attempting to make sense of the current carotid database? I believe the answer to this question is yes for the following reasons. I ) The text is well organized, with multiple data tables summarizing the important points of each topic in most of the sections. Organization of vast volumes of data is critical for the evaluation of carotid disease. 2 ) The chapters are relatively short (<lo pages), with multiple references (which are current through 1997 and include a number of European studies that the American surgeon may be less familiar with), making it a reasonable reference book for the clinical surgeon and/or the academic surgeon. 3 ) The current status of multiple evolving techniques in the moving target of diagnosis in carotid disease is presented in this format from primarily European experts on plaque morphology, stenosis interpretation, and MR/spiral angiography. 4) The current status of controversial therapeutic approaches are included (short stays for carotid endarterectomy, surgery based on duplex findings alone, and carotid angioplasty). 5) Not surprising from a book containing a predominantly European authorship, the topic of carotid angioplasty is extensively covered, with onethird of the chapters (all by European authors) devoted to aspects of this procedure. This is probably the most unique quality of the textbook as a review of carotid disease in 1999. With the ability to download abstracts from huge online library databases a reality for most surgeons, the role of textbooks has changed markedly. The books that are useful in my library are reasonably portable and current, and effectively synthesize large amounts of confusing data, illustrate with diagrams or photos, the details helpful for patient care, or present data from some unique viewpoint. They have easy-to-locate data tables and diagrams for rapid access during a typically hectic day. These books are more likely to be briefly referred to multiple times rather than read cover to cover. I believe New Trends in Carotid Disease from the European Vascular Course fits in this library.