[The choice of the surgical procedure in a multiple occlusive lesion of the arteries supplying blood to the brain].

Over 50% of ischemic lesions of the brain are caused by great artery occlusions mainly due to atherosclerosis, various arterial deformities, as well as to extravasal compressions. Almost half the patients have a concomitant two- or more artery lesions. There are many reports on the surgical treatment of multiple occlusive lesions of extracranial arteries, but the choice of surgical policy is little studied. The author's study has shown that the surgical policy largely depends on the reserves of collateral cerebral circulation and hemodynamic parameters of all arteries. In revascularization requiring a temporary arrest of blood flow along one of the great cerebral arteries, priority should be given to correction of a less hemodynamically significant artery. In patients with multiple occlusive lesions of the great arteries, preference should be given to surgeries not requiring temporary artery occlusion. For adequate cerebral circulation maintenance, it is necessary to surgically correct as many arteries as required. If required, corrections of several arteries should be made at several stages at an interval of 1.5-2 months.