0ac0009bd5e58977d6404971e7020609 321323.pdf 2ed1e907490378f436abe1e6eed98ff32888d6b3 321323.pdf 02544e15ec88cc903d17cb7db55155ab034dc02ccb5443beaeca39511bc46acf 321323.pdf Title: Modified Dynamic Lymphaticovenular Anastomosis for Surgical Management of Alzheimer Disease Subject: DOI: 10.1097/GOX.0000000000007082 Plastic & Reconstructive Surgery-Global Open, Volume. 13, Issue. 10, 2 2 OctoberOctober 20252025 Summary: Alzheimer disease (AD) is a neurodegenerative disorder that frequently results in progressive cognitive decline. Despite the extensive research conducted on AD, there is presently no solution available due to its increasing prevalence. Recent research has suggested cervical lymphaticovenular anastomosis (LVA) as a therapeutic strategy to improve lymphatic outflow and potentially reduce AD symptoms. We established an amended LVA protocol to mitigate the risk of venous reflux, a prevalent issue associated with the original LVA methodology. A 64-year-old man of Chinese descent exhibited the typical signs and symptoms of AD. The absence of substantial progress with standard medical treatment led to the consideration of LVA. We used a lower limb vein graft for the LVA, anastomosing it to the cervical lymphatic vessels and external jugular vein. The cognitive function of the patient got better after LVA, as shown by higher Mini Mental State Examination and Montreal Cognitive Assessment scores. Fewer β-amyloid and tau protein deposits were observed on positron emission tomography/computed tomography scans. No adverse occurrences or issues were observed. The success in this case demonstrated the potential role of LVA in the management of AD. However, further thorough research is required to evaluate the efficacy of our technique. (Plast Reconstr Surg Glob Open 2025;13:e7082; doi: 10.1097/GOX.0000000000007082; Published online 2 October 2025.) 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true XMP: application/pdf Modified Dynamic Lymphaticovenular Anastomosis for Surgical Management of Alzheimer Disease DOI: 10.1097/GOX.0000000000007082 Plastic & Reconstructive Surgery-Global Open, Volume. 13, Issue. 10, 2 2 OctoberOctober 20252025 Summary: Alzheimer disease (AD) is a neurodegenerative disorder that frequently results in progressive cognitive decline. Despite the extensive research conducted on AD, there is presently no solution available due to its increasing prevalence. Recent research has suggested cervical lymphaticovenular anastomosis (LVA) as a therapeutic strategy to improve lymphatic outflow and potentially reduce AD symptoms. We established an amended LVA protocol to mitigate the risk of venous reflux, a prevalent issue associated with the original LVA methodology. A 64-year-old man of Chinese descent exhibited the typical signs and symptoms of AD. The absence of substantial progress with standard medical treatment led to the consideration of LVA. We used a lower limb vein graft for the LVA, anastomosing it to the cervical lymphatic vessels and external jugular vein. The cognitive function of the patient got better after LVA, as shown by higher Mini Mental State Examination and Montreal Cognitive Assessment scores. Fewer β-amyloid and tau protein deposits were observed on positron emission tomography/computed tomography scans. No adverse occurrences or issues were observed. The success in this case demonstrated the potential role of LVA in the management of AD. However, further thorough research is required to evaluate the efficacy of our technique. (Plast Reconstr Surg Glob Open 2025;13:e7082; doi: 10.1097/GOX.0000000000007082; Published online 2 October 2025.) Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. Zhegang Zhou Xuhui Chen Wei Kou Fanbin Meng Longbiao Yu Jingjing Wen Johnson Boey Vitrag Shah Paloma Malagón 2025-09-27T15:22:14+05:30 Adobe InDesign 15.1 (Windows) 2025-09-29T12:03:42+05:30 2025-09-29T12:03:42+05:30 uuid:b0b4169f-d047-400d-8ca1-1bb29d6b366f xmp.did:D99C05A982226811822AC3339407B423 xmp.id:38c36713-0ccc-d947-bec1-af8ec6fa3711 proof:pdf 1 xmp.iid:0bec75a4-7a4e-8f4b-a078-9eb990d067a5 xmp.did:a7b0554b-0228-824a-8654-e6d5797adeb6 default converted from application/x-indesign to application/pdf Adobe InDesign 15.1 (Windows) 2025-09-27T15:22:14+05:30 converted uuid:ff222de0-19e9-4b29-8a27-f7c45037ec04 converted to PDF/A-3a Preflight 2025-09-29T12:03:42+05:30 True Adobe PDF Library 15.0 False 1 3 A http://ns.adobe.com/xap/1.0/mm/ xmpMM XMP Media Management Schema internal UUID based identifier for specific incarnation of a document InstanceID URI internal The common identifier for all versions and renditions of a document. 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Comprehensive review on Alzheimer’s disease: causes and treatment. Molecules. 2020;25:5789. Rect: 316, 141, 539, 132 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Breijyeh Z, Karaman R. Comprehensive review on Alzheimer’s disease: causes and treatment. Molecules. 2020;25:5789. Rect: 316, 131, 506, 122 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Knopman DS, Amieva H, Petersen RC, et al. Alzheimer disease. Nat Rev Dis Primers. 2021;7:1 21. Rect: 316, 121, 539, 112 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Jack CR, Jr, Andrews JS, Beach TG, et al. Revised criteria for diag-nosis and staging of Alzheimer’s disease: Alzheimer’s Association Workgroup. Alzheimers Dement. 2024;20:5143 5169. Rect: 316, 111, 429, 102 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Jack CR, Jr, Andrews JS, Beach TG, et al. Revised criteria for diag-nosis and staging of Alzheimer’s disease: Alzheimer’s Association Workgroup. Alzheimers Dement. 2024;20:5143 5169. Rect: 316, 101, 539, 92 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Jack CR, Jr, Andrews JS, Beach TG, et al. Revised criteria for diag-nosis and staging of Alzheimer’s disease: Alzheimer’s Association Workgroup. Alzheimers Dement. 2024;20:5143 5169. Rect: 316, 91, 539, 82 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Rasmussen MK, Mestre H, Nedergaard M. The glymphatic path-way in neurological disorders. Lancet Neurol. 2018;17:1016 1024. Rect: 316, 81, 492, 72 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Rasmussen MK, Mestre H, Nedergaard M. The glymphatic path-way in neurological disorders. Lancet Neurol. 2018;17:1016 1024. Rect: 316, 71, 539, 62 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Hong JP, Chen WF, Nguyen DH, et al. A proposed role for lym-phatic supermicrosurgery in the management of Alzheimer’s dis-ease: a primer for reconstructive microsurgeons. Arch Plast Surg. 2025;52:96 103. Rect: 316, 61, 539, 52 Flags: Print AppearanceDictionary: true Page: Sequence: 4 Annotations: Annotation: Subtype: Link Contents: Hong JP, Chen WF, Nguyen DH, et al. A proposed role for lym-phatic supermicrosurgery in the management of Alzheimer’s dis-ease: a primer for reconstructive microsurgeons. Arch Plast Surg. 2025;52:96 103. Rect: 61, 712, 284, 703 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Hong JP, Chen WF, Nguyen DH, et al. A proposed role for lym-phatic supermicrosurgery in the management of Alzheimer’s dis-ease: a primer for reconstructive microsurgeons. Arch Plast Surg. 2025;52:96 103. Rect: 61, 702, 284, 693 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Hong JP, Chen WF, Nguyen DH, et al. A proposed role for lym-phatic supermicrosurgery in the management of Alzheimer’s dis-ease: a primer for reconstructive microsurgeons. Arch Plast Surg. 2025;52:96 103. Rect: 61, 692, 284, 683 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Scaglioni MF, Fontein DB, Arvanitakis M, et al. Systematic review of lymphovenous anastomosis (LVA) for the treatment of lymph-edema. Microsurgery. 2017;37:947 953. Rect: 61, 682, 119, 673 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Scaglioni MF, Fontein DB, Arvanitakis M, et al. Systematic review of lymphovenous anastomosis (LVA) for the treatment of lymph-edema. Microsurgery. 2017;37:947 953. Rect: 61, 672, 284, 663 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Scaglioni MF, Fontein DB, Arvanitakis M, et al. Systematic review of lymphovenous anastomosis (LVA) for the treatment of lymph-edema. Microsurgery. 2017;37:947 953. Rect: 61, 662, 284, 653 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Lu H, Tan Y, Xie Q. Preliminary observation of deep cervical lymphatic-venous anastomosis under off-eyepiece 3D micro-scope to treat an elderly patient with cognitive impairment. Chin J Microsurg. 2002;45:570 574. Rect: 61, 652, 195, 643 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Lu H, Tan Y, Xie Q. Preliminary observation of deep cervical lymphatic-venous anastomosis under off-eyepiece 3D micro-scope to treat an elderly patient with cognitive impairment. Chin J Microsurg. 2002;45:570 574. Rect: 61, 642, 284, 633 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Lu H, Tan Y, Xie Q. Preliminary observation of deep cervical lymphatic-venous anastomosis under off-eyepiece 3D micro-scope to treat an elderly patient with cognitive impairment. Chin J Microsurg. 2002;45:570 574. Rect: 61, 632, 284, 623 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Lu H, Tan Y, Xie Q. Preliminary observation of deep cervical lymphatic-venous anastomosis under off-eyepiece 3D micro-scope to treat an elderly patient with cognitive impairment. Chin J Microsurg. 2002;45:570 574. Rect: 61, 622, 284, 613 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Li X, Zhang C, Fang Y, et al. Promising outcomes 5 weeks after a surgical cervical shunting procedure to unclog cerebral lym-phatic systems in a patient with Alzheimer’s disease. Gen Psychiatr. 2024;37:e101641. Rect: 61, 612, 163, 603 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Li X, Zhang C, Fang Y, et al. Promising outcomes 5 weeks after a surgical cervical shunting procedure to unclog cerebral lym-phatic systems in a patient with Alzheimer’s disease. Gen Psychiatr. 2024;37:e101641. Rect: 314, 712, 537, 703 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Li X, Zhang C, Fang Y, et al. Promising outcomes 5 weeks after a surgical cervical shunting procedure to unclog cerebral lym-phatic systems in a patient with Alzheimer’s disease. Gen Psychiatr. 2024;37:e101641. Rect: 314, 702, 537, 693 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Li X, Zhang C, Fang Y, et al. Promising outcomes 5 weeks after a surgical cervical shunting procedure to unclog cerebral lym-phatic systems in a patient with Alzheimer’s disease. Gen Psychiatr. 2024;37:e101641. Rect: 314, 692, 537, 683 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Yamamoto T, Yoshimatsu H, Yamamoto N, et al. Multi-site lymphaticovenular anastomosis using vein graft for uterine cancer-related lymphedema after pelvic lymphadenectomy. Vasc Endovascular Surg. 2015;49:195 200. Rect: 314, 682, 376, 673 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Yamamoto T, Yoshimatsu H, Yamamoto N, et al. Multi-site lymphaticovenular anastomosis using vein graft for uterine cancer-related lymphedema after pelvic lymphadenectomy. Vasc Endovascular Surg. 2015;49:195 200. Rect: 314, 672, 537, 663 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Yamamoto T, Yoshimatsu H, Yamamoto N, et al. Multi-site lymphaticovenular anastomosis using vein graft for uterine cancer-related lymphedema after pelvic lymphadenectomy. Vasc Endovascular Surg. 2015;49:195 200. Rect: 314, 662, 537, 653 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Contents: Yamamoto T, Yoshimatsu H, Yamamoto N, et al. 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