The objective of this study was to improve the outcomes of surgical treatment in patients presenting with chronic post-traumatic arteriovenous vascular lesions (PAVL) based on the consideration of aetiology and pathogenesis of this condition. A total of 18 patients with PAVL were examined during the period from 2005 to 2009; they were 16 men and 2 women female aged 25-57 years (half of the patients were 25-40 years of age). Damage to the arteries of the lower extremities were documented in 10 patients; 8 of them (66,7%) needed reoperation; the duration of disease ranged from 3 months to 36 years. Two patients of this group underwent ligation of the arteriovenous fistula, end-to-end arterial anastomosis was constructed in one, lateral suture was placed in one more patient, artery replacement with an explant was performed in 3, endovascular embolization in 1, and stent-grafting of arteriovenous fistula followed by surgical removal of pseudoaneurysm in 1 patient. The results of echocardiographic study carried out before and after the surgical treatment in 2 patients with PAVL of the femoral and tibial vessels indicate that such treatment promotes normalization of systemic hemodynamic disturbances. The outcomes of the endovascular treatment were analysed in 7 patients with PAVL and of the combined treatment in 2 cases. It was shown that the progress of heart failure depends on the fistula diameter, localization, and duration. The outcome of the surgical treatment depends upon the timeliness of special surgery. Radical reconstructive surgery in patients with PAVL contributes to the normalization of systemic hemodynamics in the early postoperative period. It is concluded that the combined use of surgical and endovascular methods allows to considerably decrease the risk of intraoperative hemorrhage and surgical trauma in the patients with chronic post-traumatic arteriovenous vascular lesions.