eng Oriental Scientific Publishing Company Biomedical and Pharmacology Journal 0974-6242 2017-06-20 10 2 947 951 10.13005/bpj/1189 15413 article Alexey L. Charyshkin 1 Alexander A. Maxine 2 Maxim V. Yashkov 1 Lyubov V. Matveeva 1 Alexander V. Poteryaev 2 Department of surgery, Ulyanovsk State University 432017, Leo Tolstoy Str, 42, Ulyanovsk, Russian Federation. GUZ "Ulyanovsk Regional Clinical Hospital” 432017, Third International Str., 7 Ulyanovsk, Russian Federation. A clinical case of the use of distal reconstructive vascular operations in a patient with critical ischemia of the lower limb is presented in the article. A high-risk patient with multifocal atherosclerosis suffered a bifurcational aorto-femoral shunting in 2005, an acute myocardial infarction, suffers from ischemic heart disease, exertional angina of 3 FC. After 10 years after the operation, he began to note the deterioration. Semi-closed loop endarterectomy from the right SFA and direct endarterectomy from the mouth of the right DFA was performed at the first stage. On the next stage a semi-closed loop endarterectomy from the RCA on the right and a direct endarterectomy from the mouth of ATA, PTA were performed. Was performed an overlapping of AV fistula between ATA and ATV, popliteal pedidial shunting below the knee cleft between RCA and ATA. After 43 bed days, after the stage of reconstructive vascular surgeries on the right foot by Chopar’s amputation. After 4 months, was performed the dermepenthesis of the post-surgery stump. Was examined in March 2017, the patient's condition is satisfactory. The clinical case shows that distal combined reconstructive vascular surgeries can save limbs in patients with critical ischemia of the lower limb and multifocal atherosclerosis. https://biomedpharmajournal.org/vol10no2/reconstructive-vascular-surgeries-in-a-patient-with-critical-ischemia-of-the-lower-limb-and-multifocal-atherosclerosis/ Multifocal atherosclerosis critical ischemia of the lower limb reconstructive vascular surgery endarterectomy