The authors analyze the technical aspects of aortic prosthesis in 37 patients with atherosclerotic, high occlusions of the aorta. The upper occlusion limit in this abnormality is shown to have two X-ray variants. Thoracophrenolumbotomy is considered to be the best access for proximal anastomosis in aortic prosthesis. The traditional operation technique for this abnormality has some disadvantages, the main limit of which is the necessity of shifting a patient from place to place for proximal and distal anastomoses. This makes the operation in these severe patients longer. The authors have proposed a novel procedure for aortic prosthesis by employing a special roller. The latter eliminates the necessity of shifting the patient from place to place during surgery, cuts surgical time by more than 2 hours, allows one to follow asepsis more carefully.