Since the discovery of smog by Japanese medical experts in the 1950s, international and domestic medical experts have been exploring the research of smog and the treatment of smog has been evolving and has made great progress. Smog is relatively rare, but in recent years, the incidence and detection rate of smog has increased due to increased awareness of smog and the development and popularity of imaging technology at all levels of hospitals. But after all, our awareness of smog is not long, only 60 to 70 years of history, many places are not fully aware of smog, and the treatment of smog is not particularly good, and the technology is not very mature. For example, some local hospitals adopt the stenting method to treat smog. What about bypass or stenting? Smoke disease is due to chronic progressive stenosis of the cerebral artery ring bilaterally, the main branch vessels, secondary to the formation of abnormal vascular network at the base of the skull, these abnormal vascular network in the cerebral angiography presents a bunch of piles of smoke image, so it is imaginatively called smoke disease. Then many primary care hospitals, seeing the stenosis of cerebral vessels, take the stenting approach to treat it, which we do not recommend. Because the stenosis in smog may be more than one, there may be multiple stenosis, or even diffuse stenosis, so one stent or two stents may not work, and the distal end will continue to be occluded after the stent is placed in the proximal end, so it is not very useful; in addition, the cerebral vessels in smog are very fragile, and the expansion of the stent may burst the vessels and cause cerebral hemorrhage, which is very dangerous. Therefore, stenting is generally not recommended for the treatment of smog. At present, the medical community generally believes that cerebrovascular bypass is an effective way to treat smog. At present, our team, in the widely carried out joint vascular bypass surgery clinical results are more outstanding, through the direct bypass plus patching composite procedure, the two-pronged approach, can reconstruct a better blood bypass channel for the patient’s brain, greatly improve the brain blood supply, greatly reduce the risk of stroke later.