The incidence of atherosclerotic lesions in coronary arteries combined with other vascular problems has been increasing during the last years. Hence, a rise in the number of patients with coronary heart disease, candidates for surgical myocardial revascularization. This paper reviews the history of surgical treatment of combined lesions of coronary and peripheral arteries and presents original criteria developed in A N Bakulev Research Centre of Cardiovascular Surgery for the choice of surgical strategy to treat multifocal atherosclerosis and postinfarction left ventricular aneurysm.