Aim — to present the successful experience of reconstructive operations on brachiocephalic arteries and to describe the surgical features of carotid endarterectomy performed in the department of cardiac surgery of I.M. Sechenov First First Moscow State Medical University from 2009 to 2014. Material and methods. It was performed 97 reconstructive operations on the brachiocephalic arteries. We described detailed indications for reconstructive operations on the brachiocephalic arteries, surgical technique and intraoperative neurological monitoring depending on the location and extent of atherosclerotic lesion. Results. Described technique provided good immediate results of reconstructive surgery in 93 patients. There were no deaths, 1 (1.36%) patient had ipsilateral stroke. We suggested some surgical techniques allowing to avoid errors and complications during carotid endarterectomy.