As with any type of medical procedure, endovascular procedures result in procedure-related complications (PRCs). A PRC system as part of an outcome-based practice monitoring strategy is essential. Such a program should have several features. It should be realistic, it should be standardized, it should have credibility, it must allow for comparisons with other physicians who are performing the same procedure, and it should be easily accomplished. Currently the only system in popular use is the system designed by the Society of Interventional Radiology (SIR). Definitions within this system are excessively broad and somewhat difficult to apply. This leads to inconsistencies. SIR indicates that their system is intended for use in publications of clinical research and may not be appropriate for use in routine clinical practice. There is a need for a system specifically aimed at and designed for day to day use by the practicing interventionalist whose work is not necessarily directed toward publication. We have described a system from the clinical applications viewpoint.