Smoke disease is a rare cerebrovascular disease, some patients when hearing the name of the disease, the mind will have this question, smoke disease is the brain smoke? In fact, smoker’s disease is a group of cerebrovascular diseases characterized by chronic progressive stenosis or occlusion of the major bilateral branches of the carotid ring (siphon section of the internal carotid artery and the anterior and middle cerebral arteries, sometimes including the beginning of the posterior cerebral artery), followed by the emergence of a network of small vessels with abnormal side branches. The main trunks of the anterior and middle cerebral arteries are narrowed and occluded. The basic pathological changes in smoker’s disease are extensive anomalous vascular network between the terminal trunk arteries of the internal carotid artery and the surrounding cerebral cortex, basal ganglia, thalamus and dura mater. This pathological change is the main cause of cerebral ischemia and cerebral hemorrhage, respectively. At present, surgery is the best treatment for smog according to the pathology. Is there any possibility of non-recurrence in surgical treatment of smog? At present, combined vascular bypass surgery is one of the more effective surgical methods to treat smog. Combined bypass refers to the combination of direct and indirect bypass surgery, which can induce the formation of neovascularization in a larger area while improving the local blood supply to the brain, and improve the blood supply to the brain in a larger area. After long-term follow-up, this procedure has been proven to be safe, effective and long-lasting, and can be the first choice of treatment for patients with smog.