The authors made operations on 131 patients with aneurysms of the abdominal aorta (AAA). Most severe patients were operated on using a modified resection or "exclusion" of the AAA and aorto-iliac bifurcation prosthesis with reverse formation of anastomoses. It was found that the proposed method increases safety of the operative treatment of AAA and is preferable for patients with a severe coexisting pathology.