Surgeons around the world are testing an experimental lymphatic microsurgery for Alzheimer’s disease following widespread commercial adoption in China, Nature reported. The procedure, called deep cervical lymphatic-venous anastomosis, connects tiny lymphatic vessels in the neck to nearby veins to help clear fluid and toxic waste proteins from the brain.
Microsurgeon Qingping Xie performed the first operation in September 2020 on an 84-year-old patient at Qiushi Hospital in Hangzhou. Xie adapted the method from a 1960s lymphedema treatment after noticing cognitive improvements in a 2019 tinnitus patient. The concept builds on discoveries by neuroscientists who identified fluid-filled waste clearance channels in the brain in 2012 and meningeal lymphatic vessels in 2015.
Surgeons Wei Chen of the Cleveland Clinic and Weifeng Zeng of the University of Wisconsin–Madison collaborated with Xie to report the technique in 2024. Hundreds of Chinese hospitals soon offered the operation, driven by viral videos on Douyin and WeChat where patients paid more than 200,000 yuan, or roughly $30,000. Chinese regulators intervened last year to restrict the surgery to formal clinical research, and authorities placed Xie in detention in September for undisclosed reasons.
Clinical trials and imaging data
Researchers have published more than a dozen small studies on the procedure. In February, clinicians published a study of more than 100 severe Alzheimer's patients at the First People's Hospital of Zunyi. Participants showed modest average improvements in cognitive scores alongside reductions of amyloid-β and tau proteins in cerebrospinal fluid.
Brain scans have provided preliminary physical data. Magnetic resonance imaging showed increased connectivity in the brain's default mode network following surgery. Ultrasound imaging also documented increased blood flow through the carotid arteries and jugular veins.
Scientific debate and durability
Specialists remain divided over the surgical risks, which include bleeding, infection and nerve damage. Jonathan Kipnis, a neuroimmunologist at Washington University School of Medicine in St. Louis, warned that rerouting fluid without fixing underlying blockages will cause waste congestion to return. Caregiver interviews from a study in China's Henan province also indicated that perceived cognitive gains were subtle and inconsistent.
Medical Microinstruments, a surgical robotics company based in Florida, is currently backing a 15-person clinical study of the procedure in the United States. Plastic surgeon Joon Pio Hong is running a separate clinical trial at the University of Ulsan College of Medicine in Seoul, while neuroscientists examine whether immediate improvements stem from reduced fluid pressure or rapid clearance of soluble toxic metabolites.
