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On the basis of experience in reconstructive operations on 250 patients with combined affection of the coronary arteries, abdominal aorta, and arteries of the lower limbs the authors discuss the diagnostic and tactical features of surgical management of these patients. The article dwells upon the necessary preoperative diagnostic algorithm as well as that in tactical variants of surgical treatment: (1) one-stage reconstructive operations on several vascular beds; (2) successive stage-by-stage treatment of patients with combined vascular pathology; (3) reconstructive vascular intervention on only one of the vascular beds. Correct practical solution of all these problems allowed the authors to reduce postoperative lethality to 5.4% among this grave contingent of patients with combined vascular pathology.
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