The management of extracranial cerebrovascular disease, including carotid endarterectomy (CEA), carotid stenting and medical management is performed by several specialists. Vascular surgeons perform a majority of CEA, whereas catheter-based therapies (eg, carotid artery stenting [CAS]) are performed by vascular surgeons, cardiologists, interventional radiologists, neurosurgeons, interventional neurologists, and other professionals.1,2 Because multiple treatment modalities are available for extracranial cerebrovascular disease, defining optimal therapy can be challenging particularly when different specialties—often with nonoverlapping expertise—deliver these therapeutic options.