The use of dynamic neck lymphaticovenous anastomosis (LVA) in the adjunctive treatment of Alzheimer disease: A retrospective case series

Background: Lymphovenous anastomosis (LVA) has recently emerged as a potential method for the symptomatic management of Alzheimer’s disease (AD). Building on this, we conceptualize the "dynamic neck LVA" (Dn-LVA) to illustrate the versatility of our technique. Dn-LVA utilizes a vein graft that traverses through the sternocleidomastoid muscle to facilitate the drainage of lymphatic fluid from the deep cervical lymphatic vessels to the external jugular vein. Methods: This study presents a retrospective analysis of patients who underwent DN-LVA at _ between November 2024 and January 2025. The clinical outcome was evaluated through PET/CT imaging and cognitive assessment tools, which included mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), neuropsychiatric inventory (NPI), and clinical dementia rating (CDR). The vein graft was harvested from the lower limb. Results: Five subjects were recruited into this study. Post-operative PET/CT scans revealed up to a 6. 9% increase in glucose metabolism in patient 3 and a decrease of 12. 3% in amyloid deposits and a 4. 7% reduction in tau deposits in patient 5 and patient 4, respectively. Clinically, MMSE and MoCA scores were improved by 1. 6 and 1. 4, respectively. NPI scores decreased by 5. 8 across five Overall, the CDR remained unchanged in all subjects. All grafts demonstrated vessel patency, and no postoperative complications were observed. Conclusions: DN-LVA appears to be a safe, minimally invasive procedure with potential cognitive and metabolic benefits in AD. Further studies with larger cohorts and longer follow-up are warranted to confirm these preliminary findings.