PERSPECTIVE article
Front. Aging Neurosci.
Sec. Alzheimer's Disease and Related Dementias
Rethinking Cervical Deep Lymphovenous Anastomosis in Alzheimer's Disease: Problems and Prospects
Gaiqing Wang 1
Hainyan Li 2
Sen Zhang 1
1. Sanya Central Hospital, Sanya, China
2. Anyang people’s hospital, Henan, China
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Abstract
Background: Deep cervical lymphovenous anastomosis (DCLVA) has been proposed as a novel surgical strategy to promote brain waste clearance in Alzheimer's disease (AD), inspired by advances in glymphatic and meningeal lymphatic research. Early reports suggested possible cognitive benefits, yet the scientific basis of this approach remains controversial. Discussion: This Perspective critically examines the mechanistic rationale, anatomical limitations, and methodological shortcomings underlying DCLVA. The pressure disparity between cervical lymphatic and venous systems challenges the physiological feasibility of the procedure, while existing studies lack randomized design, biomarker validation, and control for anesthesia-related confounding. Ethical and translational considerations further underscore the need for rigorous preclinical and clinical evaluation before any clinical adoption. Summary: While DCLVA reflects an innovative attempt to translate lymphatic biology into surgical therapy, its current theoretical and empirical foundation is insufficient. A shift toward mechanistic validation, objective imaging biomarkers, and noninvasive modulation of lymphatic function is warranted before DCLVA can be considered a viable therapeutic option for AD.
Summary
Keywords
Alzheimer's disease, Brain waste drainage, cerebrospinal fluid clearance, deep cervical lymphovenous anastomosis, Glymphatic system, Surgical translation
Received
11 October 2025
Accepted
06 February 2026
Copyright
© 2026 Wang, Li and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Gaiqing Wang
Disclaimer
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