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The incidence of peripheral arteries atherosclerosis varies in the general population between 3 to 10%, increasing to 15 to 20% in patients older than 70 years. Due to the high and constantly increasing prevalence, chronic obliterating diseases of lower limbs arteries (CODLLA) constitute an important medical and socioeconomic problem that cannot be solved only through wide introduction and application of various innovative surgical technologies. The fact is that even the most modern and knowledge-intensive surgical interventions do not exert a fundamental influence on the principles of the CODLLA pathogenesis. Moreover, there is no doubt that the success of arterial reconstruction and its prolongation are largely determined by adequate conservative treatment, the principles of which are discussed in this article.