Modern-day evidence-based medicine mandates a strong understanding of current local and international guidelines. We surgeons often rely heavily on these reports, but what to do when they differ? To explore this topic, Audible Bleeding (a publication of the SVS) and the ESVS podcast have partnered to create the Transatlantic Series. In this inaugural episode, we compare and contrast the SVS carotid artery disease guidelines published in 2022 with the recently updated ESVS guidelines published in 2023.Representing the American perspective, we are excited to speak with Dr. Ali AbuRahma. Dr. AbuRahma is the former president of the Society of Vascular Surgery, the Chief of Vascular and Endovascular Surgery at the Charleston Area Medical Centre at West Virginia University, and the corresponding author of the latest SVS guidelines on extracranial cerebrovascular disease.Representing the European perspective, we are delighted to speak with Dr. Barbara Rantner. Dr. Rantner is the co-chair of the 2023 European Society of Vascular Surgery Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease and a leading physician at the Ludwig-Maximillian University Hospital in Munich, Germany.