February 26, 2026 — A promising surgical procedure known as lymphovenous anastomosis (LVA) is gaining attention as a potential treatment for Alzheimer’s disease (AD). This development is highlighted in the upcoming March issue of Plastic and Reconstructive Surgery®, the official journal of the American Society of Plastic Surgeons (ASPS), published by Wolters Kluwer.
“LVA represents a novel surgical strategy targeting brain lymphatic dysfunction – potentially addressing a key factor involved in the development and progression of AD,” stated Dr. Chew Khong Yik, Senior Consultant at the Department of Plastic, Reconstruction & Aesthetic Surgery, Singapore General Hospital (SGH). Despite the enthusiasm, Dr. Chew emphasized the need for further research to fully understand the benefits of this procedure. The study was conducted by SGH in collaboration with Duke-NUS Medical School and the National Neuroscience Institute in Singapore.
Understanding Lymphovenous Anastomosis
Lymphovenous anastomosis, often referred to as lymphovenous bypass, is a minimally invasive surgery where lymphatic vessels are connected to nearby blood vessels to enhance lymphatic flow. While the concept of LVA is not new—commonly used to alleviate lymphedema caused by cancer treatments—its application in Alzheimer’s treatment is groundbreaking.
Recent research has pointed to impaired lymphatic flow in the brain, known as “glymphatic” flow, as a contributing factor to Alzheimer’s-related abnormalities, such as amyloid-beta plaques and tau protein deposits. This impaired flow can hinder the clearance of neurotoxins, especially during sleep. Although lifestyle changes and medications have been proposed to improve brain lymphatic flow, their effectiveness remains limited.
The Surgical Approach and Its Implications
By establishing a direct connection between lymphatic vessels and veins, LVA bypasses blocked or dysfunctional pathways, providing a continuous and passive enhancement of glymphatic flow. Plastic surgeons, who are adept in microsurgery and familiar with the head and neck anatomy, are uniquely qualified to perform this procedure.
Initial studies have shown promising results, with patients experiencing improved cognitive test scores and significant gains in mental and physical functioning. These clinical improvements have been linked to increased lymphatic flow, suggesting a direct correlation between the procedure and cognitive benefits.
“Together, these studies support the safety and potential cognitive benefit of LVA in AD, warranting further validation,” said Dr. Chew.
Key Considerations and Future Directions
The study outlines several critical factors for establishing the effectiveness of LVA for Alzheimer’s disease:
- Clear selection criteria targeting patients with confirmed mild to moderate AD.
- Standardized surgical approaches, including preoperative testing to map lymph and blood vessel targets.
- Defined methods for monitoring changes in cognitive function.
- Evidence confirming the mechanisms by which restoring brain glymphatic flow leads to clinical improvement.
- Data on the risks and potential complications of LVA surgery.
Dr. Chew and his coauthors concluded that “LVA represents a novel therapeutic strategy that may complement existing treatments, offering new hope for addressing the pathophysiology of AD.” They advocate for collaborative, long-term clinical trials to explore LVA not only as an adjunct to current Alzheimer’s therapies but also as a potential treatment for other neurodegenerative diseases.
The Broader Impact
This development comes at a time when the medical community is actively seeking innovative approaches to combat Alzheimer’s disease, a condition that affects millions worldwide. The potential of LVA to improve brain health by enhancing lymphatic flow could revolutionize treatment paradigms, offering a new avenue for managing not only Alzheimer’s but possibly other related conditions.
As research progresses, the medical community remains cautiously optimistic. The next steps involve rigorous clinical trials to validate these initial findings and to explore the broader implications of LVA in neurodegenerative disease management.
For further reading, explore the article titled “Exploring Lymphovenous Anastomosis for Alzheimer’s Disease: Addressing Brain Lymphatic Dysfunction, Feasibility, and Outcome Metrics” in the March issue of Plastic and Reconstructive Surgery®.
