The title of the Symposium includes “۴۰ Years of Looking Forward”. The series of books are not symposium proceedings. Far from it. These are chapters preceding the Symposium and the book is the basis of the presentations that will be delivered at the Symposium. Topics tell their own story but every year focus either on Controversies, Challenges or Consensus.

The Thoracic Controversies section includes presentations on new thoracic aortic procedures. Perhaps the cutting edge of the whole Charing Cross Symposium in 2018 is the realisation that the arch of the aorta can be reconstructed by endovascular means. However, interventions come at a risk of stroke. This was realised with the transcatheter aortic valve implantation (TAVI). Cerebral protection devices were introduced to try to limit this. Chapters in this section relate to information to control cerebral embolisation. At the meeting, results of the so-called STEP study will be discussed. Experts share their information on how to eradicate Stroke from Thoracic Endovascular Procedures. This will be illustrated by an “aortic live” performance of an endovascular arch reconstruction to show the audience just what the concerns are and how to minimise the risks. Unfortunately, in this publication that movie cannot be shown but will be online after CX.

Amongst the Abdominal Aortic Controversies, a huge area of interest is in the follow-up results of endovascular aneurysm repair (EVAR). It is widespread opinion that the original follow-up protocols were suboptimal. In the Peripheral Arterial Controversies section, a huge controversy is whether “endovascular frst” is the right slogan for management a critically ischaemic limb. Critical ischaemia was defned in 1981 with an intention to recognise that, if arterial reconstruction was not performed successfully, major amputation would follow. In many parts of the world, “endovascular frst” has become a practice but some open surgeons feel that the surgical open method is not having a fair opportunity. There are excellent chapters on this topic in the book. Vessel preparation, drugcoated balloons, stents, drug-eluting stents, bioabsorbable scaffolds all form part of the answers in peripheral arterial management.

Venous and Lymphatic Controversies focus on how to investigate, how to intervene, best effect of these conditions. Superfcial venous management has moved very much towards the use of cyanoacrylate glue occlusion. This can be done without tumescent anaesthesia. Some have found mild allergies following this procedure and the pros and cons of the use of cyanoacrylate are discussed in the book. I am personally extremely grateful to the Faculty of the Charing Cross Symposium who provided chapters for the book and to the BIBA Publishing team that has been able to create such an excellent book in time for the Symposium.