Smoker’s disease is a cerebrovascular disease discovered and named by a Japanese scholar in the 1960s. It mainly refers to the chronic progressive narrowing or occlusion of the major bilateral branches of the cerebral arterial ring, which then leads to compensatory hyperplasia of the penetrating arteries at the base of the skull, forming a network of small, fragile vessels that appear as a cloud of smoke-like images on cerebral angiography, and is therefore imaginatively called smoker’s disease. Although scholars have put forward numerous claims, including autoimmunity, family genetics, environmental factors, etc., the controversy over the pathogenesis of smog has not yet been settled due to the complexity of its cause. Smog is essentially a disease in which the vascular network of the skull base of the brain is malformed. It is possible to relieve the initial symptoms by taking medications, but it is impossible to change or correct this malformation. When the disease develops to a certain extent, it can cause cerebral ischemia or cerebral hemorrhage, which may lead to dizziness and headache, weakness of limbs and blurred vision in mild cases, and may lead to hemiplegia, disability, and even potentially life-threatening in serious cases. Thus, there is a general consensus in the medical community that conservative medical treatment of smog is of little benefit and that surgery is the only treatment once a clear diagnosis is made. The surgical treatment of smog disease is also divided into several types because of its different operations, among which there is a combined vascular bypass procedure combining direct vascular bypass and patching, which can be the first choice for the treatment of smog disease. Combined vascular bypass surgery is to build a bypass blood channel rapidly by direct bypass through a high-precision microscope to achieve rapid improvement of local blood supply, and to apply a patch to the brain surface to induce the formation of neovascularization and improve brain blood supply to a larger extent.