Is China’s ‘Alzheimer’s Surgery’ Too Good to Be True?

A new surgery that gained popularity in China promised a drug-free approach to treat Alzheimer’s. The procedure, known as deep cervical lymphatic-venous anastomosis, connects the brain’s lymphatic vessels, which carry waste, to the veins in the neck to improve drainage.

Although over 400 hospitals in China had offered the surgery, researchers haven’t rigorously tested it in clinical trials. The growing popularity, coupled with uncertainty about its safety and effectiveness, led the Chinese government to ban the surgery in July 2025, pending further research. 

“The rationale starts with the idea that brain health depends on efficient clearance of fluid and dissolved waste products,” Dr. Per Kristian Eide, a neurosurgeon and professor at Oslo University Hospital, told Being Patient. 

“The existing evidence is largely based on experimental data from animal research,” he said, and the evidence in humans is “limited.” 

Is a brain plumbing problem contributing to Alzheimer’s?

Over decades, toxic forms of the beta-amyloid protein accumulate between brain cells, eventually sparking tau to tangle within brain cells. Their buildup may contribute to inflammation, cell death, and the onset of memory loss and cognitive symptoms that define Alzheimer’s.

A network of vessels enveloping the brain, making up the lymphatic and glymphatic systems, may facilitate the removal of these potentially toxic proteins. Some research suggests that waste clearance is most active during sleep, and researchers are developing better ways to observe this in humans.

If you think of the brain as a city, “the garbage accumulates during the day, and then garbage collectors come in the evening and take everything away,” Dr. Sayed Azizi, neurologist and professor at the Yale University School of Medicine, told Being Patient. 

Still, most of the evidence implicating waste clearance in Alzheimer’s comes from experimental animal models of Alzheimer’s, not human trials. “However, mice and rats are not like humans in all respects, not least when it comes to lymphatic function,” Eide cautioned. 

Since mice and rats don’t normally get the disease, researchers need to insert human Alzheimer’s genetic mutations — meaning these models aren’t always reliable. There are some studies that measure waste clearance in the brain, but scientists are less certain about how it changes with aging or disease. 

If waste clearance is impaired with aging or in Alzheimer’s, said Eide, then this new surgery might help by giving the fluid, which carries waste, another exit route into the bloodstream. 

“By improving the drainage at the juncture between the lymphatics and the vein, you’ll basically tip the balance towards cleaning,” speculated Azizi.

Eide however cautioned that there’s a lack of evidence on whether the surgery improves waste clearance in humans. There are also no standardized measures of lymphatic flow to confirm the mechanism works.

A surgery for Alzheimer’s?

The current options for slowing the course of Alzheimer’s are limited and only available for people in the earliest stages of the disease. 

The anti-amyloid drugs Leqembi and Kisunla, expensive anti-amyloid drugs that require intravenous infusions — though after 18 months, people taking Leqembi can opt for an injectable version — and MRI monitoring for microbrain bleeds and swelling. 

A one-time surgery, such as the procedure that gained adherents in China prior to being banned, lasting two to three hours, sounds appealing by comparison.

Azizi likened anti-amyloids to “scrubbers” that get rid of waste that’s already accumulated while a surgical procedure might increase brain “washing,” leading to less accumulation of the waste.

In 2020, Chinese plastic surgeon Qinping Xi of Hangzhou Quishi Hospital performed the first surgery in an Alzheimer’s patient and promoted the surgery online, with the slogan “Stop Progressing, Start Recovering.” Other scientists in China have also published studies of this surgery, often detailing individual cases from one surgical center, without any control comparisons. 

In the last year, some Chinese scientists also published articles cautioning their colleagues around the procedure until large, well-controlled studies are conducted. 

“Reported improvements in cognition or symptoms are hard to interpret because invasive procedures can produce placebo effects, and because patient selection, concomitant treatments, and outcome measures vary widely,” said Eide. “The overall complication rate and long-term safety profile are not yet defined in large, independently replicated, well-monitored cohorts.” 

Even minimally invasive surgery poses many potential risks to older, vulnerable patients, he added, including infection, bleeding, nerve injury, and delirium.

To determine whether the surgery is safe and effective, two large trials are planned in China. The CLEAN-AD study will follow people with moderate to severe Alzheimer’s for a year after surgery while the other trial will track participants for two years. Neither study is blinded since participants will know whether or not they’re receiving the surgery. 

Another trial is planned in Singapore and a neurotechnology company is developing eyelash-sized robotic needles to pilot a treatment with a similar rationale soon. 

In the U.S., Dr. Bohdan Pomahac, the Yale plastic surgeon who performed the first face transplant in the U.S. is planning a safety study of the procedure in five patients, in collaboration with Yale’s Alzheimer’s Disease Research Center, following them for a year. If that succeeds, the procedure will be tested in 15 more individuals. 

Azizi, who is part of the research team, explained the Yale trial is a prevention study designed for people who are amyloid-positive, aiming to clear plaques before cognitive decline begins.

Though the rationale behind the surgery is scientifically plausible, its effectiveness remains uncertain. Eide said that converging evidence showing effectiveness, proof of the mechanism, and safety is needed to transition this surgery from an experimental procedure to clinical practice. 

Until then, deep cervical lymphatic-venous anastomosis remains an intriguing but unproven idea for treating Alzheimer’s.