The paper contains information about surgical occlusion of the common carotid arteries - one of the causes of chronic cerebrovascular ischemia. For the period from 2003 to the present time have been treated 25 patients with a clinical picture of cerebral ischemia due to occlusion of the common carotid artery. Performed a total of 48 surgical procedures among which subclavian-external carotid and common carotid bypasses, retrograde carotid thromboendarterectomy. In 7 cases revascularization of the brain was performed as a second stage. Choice of reconstruction type based on preoperative investigation results and intraoperative data. No persistent complications or mortality were observed. Positive clinical dynamics was noted in 80% of cases. Crossability of reconstruction area at the annual catamnesis was 84%. Prosthetic vascular graft thrombosis occurred most often (up to 40%) in patients with type 2 occlusion and in the presence of severe collateral perfusion. In patients with 1st type of occlusion of the common carotid artery reconstructive surgery have shown to be a reliable and effective treatment for chronic cerebral ischemia and prevention of recurrent ischemic stroke.