The author reports an unpublished series of 24 operated cases and considers the surgical problems raised by atheromatous stenosis and obstruction of the innominate artery. At present, excellent results may be obtained thanks to: 1) better precision of the indications, excluding patients with neurological complications undergoing aggravation or permanent neurological signs; 2) at present, operations by the cervical route should be performed when the state of the heart and lungs prevents direct surgery by sternotomy, which remains, however, the method of choice.