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Exploring Lymphovenous Anastomosis for Alzheimer Disease: Addressing Brain Lymphatic Dysfunction, Feasibility, and Outcome Metrics
Yu‐Hsin Yen, Min Wei Chen, Jia Xu Lim, Khong Yik Chew. Plastic & Reconstructive Surgery, 2025-08-11
Topic: Amyloid, tau and blood-test diagnosis
SUMMARY: Alzheimer disease is a multifactorial neurodegenerative disorder characterized by amyloid-beta plaques, tau tangles, and neuroinflammation, with emerging evidence highlighting a potential role for brain lymphatic dysfunction. Lymphovenous anastomosis (LVA), a microsurgical technique traditionally used in lymphedema management, offers a novel solution to enhance brain metabolite clearance by bypassing impaired lymphatic pathways and enhancing glymphatic outflow. By connecting lymphatic vessels to veins, LVA compensates for aging-related declines in lymphatic/glymphatic flow, with preliminary studies supporting this theory. This review evaluates the feasibility of LVA, emphasizing key anatomical targets such as cervical lymphatic vessels, while proposing robust patient selection criteria. It also aims to address the controversies in outcome measures including advanced imaging, biomarker analysis, and cognitive assessments. Although early findings are promising, further research is essential to optimize surgical protocols, clarify biological mechanisms, and ensure safety. LVA represents a novel therapeutic strategy that may complement existing treatments, offering new hope for addressing the inevitable outcome of Alzheimer disease.
Key findings
- By connecting lymphatic vessels to veins, LVA compensates for aging-related declines in lymphatic/glymphatic flow, with preliminary studies supporting this theory.
- This review evaluates the feasibility of LVA, emphasizing key anatomical targets such as cervical lymphatic vessels, while proposing robust patient selection criteria.
- It also aims to address the controversies in outcome measures including advanced imaging, biomarker analysis, and cognitive assessments.
- Although early findings are promising, further research is essential to optimize surgical protocols, clarify biological mechanisms, and ensure safety.
- LVA represents a novel therapeutic strategy that may complement existing treatments, offering new hope for addressing the inevitable outcome of Alzheimer disease.
Why it matters
This review proposes lymphovenous anastomosis surgery as a way to improve clearance of brain waste products, but it reports only preliminary supporting evidence and calls for more research on protocols, mechanisms, and safety. It is not an established treatment, and no outcomes in Alzheimer's patients are reported.
Study details
- Evidence strengthLow
How this study scored 38/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Plastic & Reconstructive Surgery) |
| Journal's citation record | 3 / 4 | Plastic & Reconstructive Surgery: journal h-index 310 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 6 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Khong Yik Chew: h-index 12 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Duke-NUS Medical School: institution h-index 612 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40794118) |
| Free to read | 2 / 2 | Free to read |
| Total | 38 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1097/prs.0000000000012364
- PubMed: 40794118
- Original source →
- Free full text: Plastic & Reconstructive Surgery →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Yen, Y., Chen, M. W., Lim, J. X., & Chew, K. Y. (2025). Exploring Lymphovenous Anastomosis for Alzheimer Disease: Addressing Brain Lymphatic Dysfunction, Feasibility, and Outcome Metrics. Plastic & Reconstructive Surgery. https://doi.org/10.1097/prs.0000000000012364
Vancouver
Yen Y, Chen MW, Lim JX, Chew KY. Exploring Lymphovenous Anastomosis for Alzheimer Disease: Addressing Brain Lymphatic Dysfunction, Feasibility, and Outcome Metrics. Plastic & Reconstructive Surgery. 2025. doi:10.1097/prs.0000000000012364. PMID: 40794118.
BibTeX
@article{yen2025-40794118,
author = {Yen, Yu‐Hsin and Chen, Min Wei and Lim, Jia Xu and Chew, Khong Yik},
title = {{Exploring Lymphovenous Anastomosis for Alzheimer Disease: Addressing Brain Lymphatic Dysfunction, Feasibility, and Outcome Metrics}},
journal = {Plastic \& Reconstructive Surgery},
year = {2025},
doi = {10.1097/prs.0000000000012364},
pmid = {40794118},
url = {https://doi.org/10.1097/prs.0000000000012364}
}
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