In neurosurgery clinic, we sometimes encounter some strange diseases, for example, some people have a sudden attack of cerebral infarction or cerebral hemorrhage, but the various examinations cannot find out any cause or primary disease, and further refinement of cerebral angiography may be diagnosed as smog. So what is this smog disease? Smoke disease is a rare cerebrovascular disease that many people may not have heard of, and many primary care workers do not even know about it. This disease was originally discovered and named by a Japanese scholar in the 1960s. It is mainly a chronic progressive stenosis or occlusion of the main bilateral branches of the cerebral artery ring, which then leads to compensatory hyperplasia of the penetrating arteries at the base of the skull, forming a small and fragile network of small vessels, and presenting a cloud of smoke-like images during cerebral angiography, so this disease is imaginatively called smog. Smoke disease is very dangerous, as mentioned earlier, it can cause brain hemorrhage and cerebral infarction at any time, which can cause neurological dysfunction in mild cases and can be life-threatening in severe cases. Therefore, once the disease is detected and diagnosed as smog, it should be treated surgically as soon as possible. Because the current conservative medical treatment for smog disease is generally of little significance, surgery is the way to treat smog disease. Currently, combined vascular bypass surgery is a very effective surgical procedure for the treatment of smog, and has unparalleled advantages compared to traditional direct vascular bypass surgery and indirect vascular bypass surgery (also known as patch surgery). Combined vascular bypass surgery is a dual procedure of direct bypass + patching, and both procedures are done in the same surgery to achieve a more desirable result.