Vascular diseases, particularly occlusive lesions of major arteries, remain among the leading causes of disability and mortality. A special clinical challenge is posed by combined lesions of the brachiocephalic arteries and the terminal segment of the aorta, which reflect the multifocal nature of atherosclerosis and are associated with a high risk of stroke, critical limb ischemia, and multiple organ failure. This article reviews current concepts of the pathogenesis of such conditions, their epidemiological significance, and diagnostic opportunities, including duplex ultrasonography, multislice computed tomography, and magnetic resonance angiography. Particular attention is given to a comparative analysis of surgical, endovascular, and hybrid treatment modalities, as well as to the choice of optimal patient management strategies. A promising direction is the personalized approach, which incorporates comprehensive diagnostic and therapeutic algorithms aimed at reducing the risks of stroke, amputation, and improving long-term outcomes.

Occlusive lesions, brachiocephalic arteries, terminal aorta, multifocal atherosclerosis

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