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The literature review presents the possibilities and current trends in the use of hybrid surgery in patients with multilevel multifocal lesions of the arterial bed of the lower extremities with obliterating lesions. Methods of open bypass surgery for chronic atherosclerosis of the arteries have long been developed, put into practice and can be considered individually for each patient. However, given the frequent complicated atherosclerotic history in patients with multifocal lesions of various arterial pools, most patients can be recommended more gentle endovascular methods of blood flow correction — balloon angioplasty or stenting. But given certain technical and general parameters (prolonged occlusion, severe calcification, kidney disease, an allergic reaction to a contrast drug, etc.), it is not yet possible to use intravascular correction in absolutely all patients, as a result of which the method of simultaneous or phased hybrid surgery seems to be very relevant and can be used even in patients at extremely high risk. The review describes the possible uses of hybrid technology depending on the level of steno-occlusive lesion and the general prolongation of narrowing of the arterial bed. Also considered are some features of the use of simultaneous or multi-stage hybrid operations. On the basis of modern literature data, the advantage of using a combination of open surgeries and endovascular interventions in comparison with any one revascularization method is shown.

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