Singapore trial explores lymphatic bypass surgery as potential Alzheimer’s treatment

“The lymphatic system basically helps to collect and drain fluid high in protein from the body back into the blood circulatory system,” explained Clinical Assistant Professor Vincent Tay, a consultant with CGH’s Plastic, Reconstructive & Aesthetic Surgery Service, Department of Surgery. He is also the principal investigator of the CLyVeB-AD-1 trial.

Using a microsurgical technique known as lymphaticovenous anastomosis (LVA), lymphatic structures such as lymph nodes on each side of the neck are connected to adjacent veins to improve clearance for the protein-carrying brain fluid. 

“The surgical principles are similar – creating bypass pathways for fluid drainage. By connecting neck lymphatic structures to veins to enhance the brain’s natural waste clearance system, we can potentially help clear the toxic proteins that accumulate in Alzheimer’s disease,” said Clinical Assistant Professor Jeremy Sun, the head and a senior consultant with CGH’s Plastic, Reconstructive & Aesthetic Surgery Service, Department of Surgery. 

The multidisciplinary team participating in the CLyVeB-AD-1 trial travelled to Hangzhou, China, where LVA was first used in the treatment of Alzheimer’s disease, to learn about the technique in 2024. 

The team then obtained approval from the Institutional Review Board, and is prospectively registered on clinicaltrials.gov. The CLyVeB-AD-1 trial is the first regulated clinical trial of its kind in Singapore and Southeast Asia.