Smoker’s disease is a rare and very aggressive cerebrovascular disease. The disease is caused by the progressive narrowing and occlusion of the main arteries of the brain, which in turn leads to compensatory growth of the penetrating arteries at the base of the skull, forming a network of tiny abnormal vessels to compensate for the lack of blood supply caused by the narrowed and occluded arteries. These abnormal vascular networks at the base of the skull appear as a cloud of smoke on cerebral angiography, which is why the disease is imaginatively called smog. Experts recommend that once the diagnosis of smog is confirmed, it should be treated surgically as soon as possible. What are the consequences of untreated smoker’s disease? The consequences are quite serious! Smog is very dangerous and can cause cerebral infarction and cerebral hemorrhage at any time, while serious cerebral infarction and cerebral hemorrhage can be directly life-threatening. In patients with smoker’s disease, the main arteries of the brain are narrowed or occluded causing blood supply disorders, and when the abnormal blood vessels at the base of the skull are not enough to compensate for this blood supply disorder, it will cause cerebral ischemia and cerebral infarction; and the abnormal smoker’s vessels formed at the base of the skull have very thin and fragile walls, so they are very likely to rupture and cause cerebral hemorrhage. This is a very serious consequence, so patients should be treated as soon as possible. The 16-year-old Li was suffering from cerebral blood supply deficiency caused by smog, often suddenly feeling dizzy, limb weakness, black eyes, and at first went to the hospital, all indicators are normal. It took several visits to the hospital to line up the cerebral blood vessels and diagnose smog, which could not be cured locally. The family brought Xiao Li to our clinic after multiple understandings. After we received him, we made a full scientific diagnosis and evaluation of his condition, and the relevant experts of the department discussed and formulated a scientific and thorough treatment plan, and performed a joint vascular bypass surgery for the patient. After the surgery, Xiao Li’s condition was greatly improved, and all symptoms were gradually relieved, and he was discharged from the hospital two weeks later. Our combined vascular bypass surgery is an effective way to treat smog. The combined vascular bypass surgery is different from the traditional direct bypass or patching, but the direct bypass and patching are combined in the same surgery to achieve rapid improvement of cerebral blood supply through direct bypass, while multifactorial patching, including muscle patching, vascular patching, dural reversal and cranial periosteal patching, is performed to induce the formation of neovascularization in a larger scale and further expand the scope of improving blood supply. Further expand the scope of improving blood supply to achieve a more ideal treatment effect.