Modern opportunities for surgical treatment of multiple lesions of brachiocephal arteries

Despite the progress of angioneurology and vascular surgery, in multiple and combined lesions of the aortic arch branches the questions of indications and contraindications to surgery, surgical tactics, and types and order of operations remain disputable. In the paper we present an example of combined surgical revascularization of the brain in a patient with abnormal circulation in both carotid and vertebrobasilar systems resulted from multiple atherosclerotic lesions of the brachiocephal arteries. The expanding application to practice of non-invasive endovascular methods, used along with traditional reconstructive operations on vessels, broadens significantly the opportunities for surgical treatment in this complex group of patients.