Own experience of extraanatomical reconstruction, made for atherosclerotic affection of the aortal arch branches, was analyzed. A subclavian artery (SA) transposition into common carotid artery (CCA) was conducted for symptomatic subtotal stenosis or occlusion of the SA I segment. While extension of atherosclerotic process beyond boundaries of the SA I segment or technical difficulties a carotid-subclavian shunting was preferred. Carotid-carotid shunting was applied in necessity of revascularization of extracranial arteries before endovascular implantation of a stent-graft down to aortal arch with closure of the left CCA branching. The authors consider extraanatomic reconstruction the method of choice in the patients surgical treatment for central atherosclerotic affection of the aortal arch branches, when possibilities of endovascular revascularization methods are exhausted, and this guarantees good and satisfactory results in 91.7% of them.