The disease is caused by the progressive occlusion of the ends of the internal carotid arteries bilaterally and the compensatory expansion of some capillaries at the base of the brain, forming dense capillaries, which appear to be a patch of blood vessels on the vascular image and look like a cloud of smoke on the imaging, so it is called smog disease. Most patients with smog disease suffer from narrowing or occlusion of the large arteries at the base of the brain, resulting in insufficient blood supply to the brain, which can lead to paralysis, headache, aphasia, blindness, mental retardation, epilepsy, brain atrophy and other symptoms. The disease often occurs in children under 10 years old and middle-aged people around 40 years old. Once diagnosed, there are no effective drugs to treat the disease, and surgery is the only radical cure. The younger the child with smog, the better the prognosis. The main effect of surgical treatment is to increase the amount of blood circulating in the brain, while conservative treatment will lead to a poor prognosis. Aggressive surgical treatment of children with smog can improve quality of life and reduce the risk of ischemic disease, and early diagnosis and surgery will result in a good prognosis for children with smog. Surgery for smog, combined with vascular bypass for smog, is currently the main surgical procedure. It is a combination procedure in which both direct bypass + indirect bypass are performed in a single procedure. The direct bypass quickly establishes blood flow side branch channels to improve local blood supply to the brain, while the indirect bypass is performed to induce the formation of neovascularization in a larger area to improve the blood supply to the brain on a larger scale, allowing the patient to have good improvement in the symptoms of brain ischemia and make the complications disappear.