Smog is a rare cerebrovascular disease, which was first discovered by Japanese scholars in the 1950s and 1960s. After six or seven decades of research and development, a major breakthrough has been made in the treatment of smog, and modern medicine has been able to deal with this sinister and rare disease with ease. The traditional surgical treatment for smog is usually a patch procedure, so what is the effect of smog patch surgery? The traditional patching procedure is usually temporal muscle patching, that is, a part of the temporal muscle with strong vascular regenerative ability is applied to the ischemic area of the skull base, in order to induce neovascularization and improve blood supply; some procedures also expand the patching factors, adding dura mater and other patching factors. However, the effect of patching is limited because it takes about 3-6 months for neovascularization to form, and there is still a possibility of morbidity during this period; in addition, about 40%-50% of adults have weak vascular regeneration ability and are unable to form neovascularization. Therefore, patching is less than ideal. At present, a better way to treat smog is our combined vascular bypass surgery, which is a dual procedure of direct bypass + patching. It can rapidly improve the blood flow of the main vessels through direct bypass, and at the same time, multi-factor patching of the skull base malformation can induce the formation of neovascularization and expand the scope of blood supply improvement.