Amerikanische Gesellschaft für Hirudotherapie

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Curated knowledge libraryReference collection

Conditions

10

Venous Congestion in Surgical Flaps

Tier A

FDA-cleared application: medicinal leech therapy to relieve venous congestion in compromised tissue flaps awaiting vascular ingrowth.

FDA-cleared device indicationFDA-cleared regulatory context

Microsurgical Replantation (Digit / Ear / Scalp)

Tier A

FDA-cleared application: post-replantation venous decompression in digits, ears, scalp, and partial avulsion injuries.

FDA-cleared device indicationFDA-cleared regulatory context

Breast Reconstruction Flap Salvage

Tier A

FDA-cleared application: venous decompression of compromised DIEP, TRAM, and latissimus dorsi flaps in post-mastectomy reconstruction.

FDA-cleared device indicationFDA-cleared regulatory context

Chronic Venous Insufficiency (CEAP C3-C5)

Tier B

Off-label use with controlled trial evidence for symptomatic improvement in venous claudication, leg heaviness, and edema in CEAP C3-C5 stages.

Studied off-labelRCT

Venous Leg Ulcer

Tier B

Off-label adjunct to compression therapy with case-series evidence for accelerated healing in compression-resistant venous ulcers.

Studied off-labelCohort / case series

Post-Thrombotic Syndrome

Tier B

Off-label use with case-series evidence for symptomatic relief of leg pain, heaviness, and ulceration in PTS following deep vein thrombosis.

Studied off-labelCohort / case series

Lumbar Radiculopathy (Sciatica)

Tier B

Off-label use with controlled trial evidence (n=80) showing leg pain and Oswestry score improvement at 4-12 weeks in non-surgical lumbar disc disease.

Studied off-labelRCT

Congestive Heart Failure (Compensated, Investigational Adjunct)

Tier C

Investigational adjunct in compensated NYHA II heart failure; no RCT support; guideline-directed medical therapy remains primary.

InvestigationalCase report

Adenomyosis (Investigational Palliative Adjunct)

Tier C

Investigational palliative adjunct for adenomyosis-related dysmenorrhea and pelvic pain; hormonal therapy (LNG-IUD, dienogest, GnRH antagonists) and (definitively) hysterectomy remain evidence-based.

InvestigationalCase report

Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (Investigational Adjunct)

Tier C

Investigational adjunct for ME/CFS symptom management; pacing strategies, post-exertional malaise avoidance, and individualized supportive care remain primary; graded exercise therapy is no longer recommended per updated NICE guidance.

InvestigationalCase report

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