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Open vascular neurosurgery has been transformed by the widespread implementation of endovascular techniques and stereotactic radiosurgery. Aneurysms once treated with microsurgical clipping are now coiled, pipelined, or treated with intravascular flow diverters. Aneurysms at the basilar bifurcation and paraclinoid internal carotid artery, which helped incorporate orbitozygomatic craniotomies and anterior clinoidectomies into open vascular neurosurgery, are no longer routinely clipped, and many trainees have never seen these skull base surgical techniques. Similarly, arteriovenous malformations, once resected microsurgically, are now typically embolized and treated with radiosurgery or managed conservatively. Open vascular case volume has decreased, and more neurosurgeons use a hybrid open and endovascular approach focused on the specific disease rather than on particular operative techniques. Prof. Adnan Hussain Siddiqui is giving "Hybrid Vascular Neurosurgery" lecture, don't miss it!