Toast the pistachios in a dry skillet over medium heat until lightly golden brown. Let them cool, then finely chop or grind them.
Pour the milk and heavy cream into a medium saucepan, then add the vanilla extract and finely ground pistachios. Gently heat over medium heat until steaming, but do not boil!
In another bowl, combine the sugar and egg yolks, whisking until lighter in color and creamy.
Gradually add a ladleful of the warm milk to the egg mixture, whisking constantly to temper the eggs. This helps prevent the eggs from scrambling.
Pour the tempered egg mixture back into the saucepan with the remaining milk. Cook over low heat, stirring constantly, until the custard thickens enough to coat the back of a spoon (about 5-7 minutes). Do not let it boil!
Strain the mixture through a fine-mesh sieve to remove any larger pistachio pieces and thicker parts. Let it cool completely to room temperature, then refrigerate for at least 4 hours to allow the flavors to meld.
If you have an ice cream maker, pour the mixture into it and churn according to the manufacturer's instructions. If not, pour the mixture into a deep bowl and place it in the freezer, stirring with a fork every half hour to keep it creamy.
Before serving, let the ice cream rest at room temperature for a few minutes to make it easier to scoop. Garnish with coarsely chopped pistachios or a drizzle of honey.
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