Smoker’s disease is a relatively rare cerebrovascular disease. It was initially first identified and named by Japanese medical experts in the 1950s. The disease is caused by chronic progressive stenosis of the major bilateral branches of the cerebral arterial ring, which in turn leads to compensatory abnormal growth of the penetrating arteries at the base of the skull, forming a network of tiny abnormal vessels that appear like a cloud of smoke when a cerebral angiogram is performed, hence the name smog. The diagnosis of smog is usually made by cerebral angiography, which is the gold standard for diagnosing smog. Cerebral angiography, also known as digital silhouette angiography (DSA), is an invasive test that involves puncturing the femoral artery, or the root of the thigh, inserting a catheter, walking to the neck, and injecting a contrast medium. Cerebral angiography is the gold standard for the diagnosis of smog. If smog is clearly identified by cerebral angiography, early surgical treatment is recommended if it meets the indications for surgery. For the treatment of smog, medical experts generally believe that conservative treatment is of little significance and that surgical intervention is needed to achieve better results. Combined vascular bypass surgery, which our team is currently performing extensively, is an effective means of treating smog. Combined vascular bypass surgery is a composite procedure in which the traditional direct vascular bypass and patching are done together in the same surgery. The direct bypass rapidly improves the local blood supply to the brain to prevent short-term stroke, while multifactorial patching is performed on the brain surface, including temporal muscle patching, cranial periosteal patching, dural reversal, vascular patching, etc., to induce neovascularization on a larger scale and expand the This will help to induce a wider range of neovascularization, expand the blood supply, and achieve a more desirable therapeutic effect.