Smoky disease is not an odd disease, nor is it rare, and in recent years has taken on an increasingly important role in the etiology of stroke. However, it is easily misdiagnosed and missed in clinical practice due to the lack of awareness of the disease. Screening for early symptoms and timely CTA or MRA or DSA examination can often confirm the diagnosis, followed by early surgical intervention, which often leads to a good prognosis. In recent years, with the progress of society and medical development, smog is no longer an incurable disease, and the current application of surgical treatment of smog has received better results. Surgery mainly includes direct revascularization (intracranial and extracranial vascular bypass) and indirect revascularization (cerebral-dural-arterial vascularization, multi-point drilling, temporalis muscle patch and dural reversal, etc.) and comprehensive treatment, of which comprehensive surgery is the most advanced treatment plan in the world today, combining the two previous surgical methods. Revascularization is similar to the “South-North Water Transfer” project. Direct revascularization surgery, which we refer to as vascular bypass, is to connect the superficial temporal artery outside the skull directly to the cortical vessels inside the skull. It is like a blocked pipe in a crop field that prevents the crop from being irrigated, so in order to relieve the drought, water is brought in from elsewhere. Bypass bridges can directly improve the blood supply to the brain. Indirect blood flow reconstruction surgery involves attaching extracranial blood supply rich muscles and meningeal tissues, etc. to the surface of the brain inside the skull, from which the brain automatically attracts blood vessels to form spontaneous anastomoses with the cortical vessels. By reconstructing the extracranial blood flow to the intracranial brain to relieve the inadequate blood supply of the intracerebral arteries, the intracerebral blood flow is improved by establishing the pathway of blood supply from the normal blood vessels outside the brain to the intracerebral brain. After the blood supply of the brain is improved, the demand for smoke-like vessels will gradually decrease, thus reducing the risk of re-occurrence of cerebral ischemia and cerebral hemorrhage and improving the prognosis of the patients. There is also therapeutic value in applying remote pre-ischemic training methods, or medications that promote blood collateral circulation compensation and vascular neovascularization.