Smoker’s disease is a chronic progressive cerebrovascular occlusive disease of unknown origin, whose clinical manifestations are mainly transient ischemic attack (TIA) or cerebral infarction in children and a 50/50 split between cerebral hemorrhage and cerebral ischemia in adults [6]. In this study, both groups of patients were adults and had TIA or cerebral infarction as the first symptom. To date, there is no ideal treatment for MMD. The main drugs currently applied in internal medicine are: antiplatelet aggregation drugs, vasodilator drugs, corticosteroids, drugs to improve microcirculation and neurotrophic drugs for symptomatic treatment. Anti-platelet aggregation drugs mainly prevent cerebral embolism by preventing the formation of microthrombi in arterial stenoses; calcium antagonists can reduce the frequency and severity of recurrent TIAs and are effective for refractory headaches or migraines in patients with MMD, but should be used with caution in patients with MMD because they can cause a drop in blood pressure [31]. A recent study showed that hemodialysis was effective in patients with smog. This study also found a 5.6% cumulative 5-year risk of ischemia or hemorrhage after surgical treatment in symptomatic patients compared with 65% in patients treated conservatively. In conclusion, the efficacy of conservative medical treatment is not conclusive, and surgical revascularization is the primary means of improving hemodynamics and reducing secondary stroke. We currently treat smoldering disease with direct combined with indirect revascularization surgery, which involves freeing the superficial temporal artery and anastomosing it directly to the intracranial middle cerebral artery branches, while reversing the dura and affixing the temporalis muscle to the brain surface. The advantage of this procedure is triple blood supply reconstruction, which maximizes the improvement of intracranial ischemic brain tissue blood supply and achieves better clinical treatment results.