Peripheral (non-cardiac) endovascular interventions have penetrated the field of vascular surgery, and it is the standard of care in many occasions. Compared to traditional open peripheral operations, the minimal access and image-guided interventions have many advantages including shorter hospital stay and faster patient recovery. However, the interventions remain a high-risk procedure due to patients advanced age and significant comorbidities such as coronary artery disease and chronic renal and pulmonary disease. Procedure-specific factors further modulate the pre-existing risk factors and may add further complications during the procedure and in the postprocedural period. For example, in patients undergoing thoracic endovascular aortic repair (TEVAR), specific complications such as spinal cord injury and stroke are the focus of intraprocedural neurophysiologic monitoring, because neurological deficits remain of the most devastating complications after peripheral endovascular interventions.