The last decade in Europe has been characterized by endovas cular surgery becoming more widespread, facilitated by a multidisciplinary approach and a relatively easy "European Conformity" marking process. Dedicated vascular registries and randomized controlled trials have been established in European countries to ensure that evolving endovascular tech niques can be monitored. Several randomized controlled trials are ongoing that will require a long time, a large sample size, and funding. The proposal that commercial companies should contribute financially to such trials seems controversial. Dedicated registries and online surveys continue to have a role in gathering data and monitoring outcomes of endovascular procedures. Continuous and accurate monitoring of endovascular practice, which is increasing in Europe, is essential to ensure a balance between patient benefit and industrial pressure.
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