Smart Library

Off-label adjunct to compression therapy; the evidence is one 20-patient uncontrolled series in complicated varicose veins plus case reports.

Investigational adjunctive use with only non-randomized clinical reports identified; proposed mechanisms are blood-volume removal and hirudin effects on vessels; not a substitute for pharmacotherapy.

Investigational use for symptomatic relief of grade II-III internal/external hemorrhoidal disease; does not address anatomic prolapse.

Investigational adjunctive use in primary open-angle glaucoma; weak case-series evidence. Not a substitute for IOP-lowering eye drops or surgery.

Investigational use for non-discogenic sciatica including piriformis syndrome; no controlled trial, only an old unquantified Russian case series.

Investigational adjunct, not a primary treatment; a few small, mostly uncontrolled studies report lower PASI scores.

Investigational use for localized refractory eczema; evidence is limited to a few small studies without placebo or standard-care controls.

Investigational use for keloid and hypertrophic scars; evidence is limited to one small uncontrolled series and two conflicting single-patient reports.

Investigational for category III CP/CPPS: evidence is limited to a 3-patient case report and an uncontrolled Russian series; multimodal therapy remains standard.

Investigational adjunctive use for chronic endometriosis-related pelvic pain; very limited evidence. Not a substitute for hormonal or surgical management.

Investigational for non-specific chronic pelvic pain; the only clinical report located is an uncontrolled 60-woman series in which leeches were one part of multimodal care.

Investigational for tinnitus; small non-randomized studies, mostly Russian, report less ear noise, and no study using the Tinnitus Handicap Inventory was identified.

Investigational use for mild-to-moderate carpal tunnel syndrome; only one single-patient case report and one randomized-trial protocol without results were identified.

Investigational adjunct for adult recalcitrant atopic dermatitis (EASI >21) refractory to dupilumab or JAK inhibitor; only small studies in general eczema.

Investigational adjunct for chronic plaque psoriasis recalcitrant to biologic therapy; only small, mostly uncontrolled studies, none in refractory disease.

Highly investigational use for severe nodulocystic acne refractory to isotretinoin; small Ayurvedic studies only, none in refractory disease, and scarring risk concerns.

Investigational adjunct for papulopustular rosacea with persistent inflammatory lesions; evidence is one small uncontrolled Ayurvedic study.

Investigational adjunct for hypertrophic scars (within the original wound), distinct from keloid; evidence is one small uncontrolled Russian series.

Investigational adjunct in compensated NYHA II heart failure; only small open-label or uncontrolled studies were identified, mostly in Russian-language sources; guideline-directed medical therapy remains primary.

Investigational adjunct to physical/occupational therapy in chronic post-stroke hemiplegia; no RCT support; not for acute stroke care.

Highly investigational adjunct in stable Hashimoto's thyroiditis; small uncontrolled series only; levothyroxine replacement remains primary.

Investigational extended-protocol adjunct for NIH Category III chronic prostatitis/CPPS; uncontrolled case series only; UPOINT-directed therapy remains primary.

Highly investigational extended-protocol adjunct for stable Peyronie's disease; one uncontrolled Russian series only; collagenase clostridium histolyticum and surgical correction remain primary.

Highly investigational adjunct for non-cirrhotic hepatic congestion; uncontrolled Russian series only; cirrhosis and portal hypertension are absolute exclusions.

Investigational adjunct for chronic temporomandibular joint disorder; conservative care (education, jaw exercises, occlusal splint, NSAIDs) remains first-line; specialty referral for refractory cases.

Investigational adjunct for symptomatic benign prostatic hyperplasia; alpha-blockers, 5-alpha-reductase inhibitors, and minimally invasive surgical therapy remain evidence-based.

Palliative investigational adjunct for endometrioma-related chronic pelvic pain in patients declining or unable to undergo surgical/hormonal management.

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

Investigational adjunct for chronic refractory subjective tinnitus; cognitive behavioral therapy, sound therapy, and hearing aids for concurrent hearing loss remain evidence-based.

Investigational adjunct for chronic non-allergic rhinitis; intranasal corticosteroids, intranasal antihistamines, and trigger avoidance remain evidence-based.

Investigational adjunct for axial pain in ankylosing spondylitis; NSAIDs, biologic DMARDs (TNF and IL-17 inhibitors), and structured exercise remain evidence-based first-line therapy.

Investigational adjunct for primary burning mouth syndrome; clonazepam (topical or systemic), alpha-lipoic acid, low-dose tricyclics, and cognitive behavioral therapy remain evidence-based.

Nigar Z, Alam MA (2011) · Ancient Science of Life

Rai PK, Singh AK, Singh OP, Rai NP, Dwivedi AK (2011) · Ayu

Whitaker IS, Josty IC, Hawkins S, Azzopardi E, Naderi N, Graf J, Damaris L, Lineaweaver WC, Kon M (2011) · Microsurgery

Pannucci CJ, Nelson JA, Chung CU, Fischer JP, Kanchwala SK, Kovach SJ, Serletti JM, Wu LC (2014) · Microsurgery

Resch JC, Hedstrom R, Steiner ME, Said SM, Somani A (2023) · Frontiers in Pediatrics

Farzali S, Yaraliyeva S, Huseynov F, Manafov A, Saglam N (2025) · Turkiye Parazitolojii Dergisi

Ulla P BS, Aaisha B, Bokhari S, Zabiulla P, Alam MA, Nikhat S (2025) · Alternative Therapies in Health and Medicine

Kameda Y, Motomiya M, Watanabe N, Ota M, Iwasaki N (2025) · JPRAS Open

Buntic RF, Brooks D (2010) · The Journal of Hand Surgery

Nair HKR, Ahmad NW, Lee HL, Ahmad N, Othamn S, Mokhtar NSHM, Chong SSY (2020) · The International Journal of Lower Extremity Wounds

Rothenberger J, Petersen W, Schaller HE, Held M (2016) · Wound Repair and Regeneration

Reese K, Gümbel D, Seifert J, Daeschlein G, Napp M, Ekkernkamp A (2015) · Handchirurgie, Mikrochirurgie, plastische Chirurgie

Aminov R (2025) · Annals of Parasitology

Wilmer A, Slater K, Yip J, Carr N, Grant J (2013) · Microsurgery

Kruer RM, Barton CA, Roberti G, Gilbert B, McMillian WD (2014) · Journal of Reconstructive Microsurgery

Kucur C, Durmus K, Uysal IO, Old M, Agrawal A, Arshad H, Teknos TN, Ozer E (2015) · European Archives of Oto-Rhino-Laryngology

Harun A, Kruer RM, Lee A, Boahene K, Byrne PJ, Richmon JD (2018) · Microsurgery

Arami A, Gurevitz S, Palti R, Menachem S, Berelowitz M, Yaffe B (2018) · Journal of Hand Surgery (American Volume)

Moen G, Dillon J (2025) · Journal of Oral and Maxillofacial Surgery

Brauer PR, Saadah M, Fritz MA, Wu SS, Lamarre ED (2024) · American Journal of Otolaryngology

Bishop JL, Vasudev M, Garcia N, Heslop G, Pham TT, Hicks MD, Chowdhury F, Grayson JW, Goddard JA, Tjoa T, Haidar Y, Thomas CM (2023) · Otolaryngology — Head and Neck Surgery (American Academy of Otolaryngology)

Trigonis R, Smith N, Porter S, Anderson E, Jennings M, Kapoor R, Hage C, Moiz S, Garcia J, Rahman O (2021) · Journal of Cardiothoracic and Vascular Anesthesia

Hamzah M, Seelhammer TG, Beshish AG, Byrnes J, Yabrodi M, Szadkowski A, Lutfi R, Andrijasevic N, Hock K, Worley S, Macrae DJ (2023) · Thrombosis Research

Engel ER, Perry T, Block M, Palumbo JS, Lorts A, Luchtman-Jones L (2024) · Pediatric Critical Care Medicine

Brandewie K, Lorts A, Luchtman-Jones L, Gao Z, Geer B, Villa C, Perry T (2024) · Journal of Artificial Organs

Iaprintsev V, Fricke TA, Buratto E, Zubritskiy A, Perrier S, Eastaugh L, Barnes C, Sheridan B, Naimo PS, Brizard CP, Mathew J, Konstantinov IE (2025) · JTCVS Open

Bryant ME, Regan WL, Fynn-Thompson F, Hoganson D, Nasr VG, Zaleski K, Faella K, Matte GS (2018) · Perfusion

Chaudhry-Waterman N, Schardt TQ, Soderstrom RM, Warren BB, Buckvold S, Morgan G, Kim JS (2025) · ASAIO Journal

Zaidi SM (2014) · International Wound Journal

Sonmez E, Safak T (2011) · Journal of Reconstructive Microsurgery

Akhoondinasab MR, Farahmand HR, Zahedi A, Saraee A (2023) · World Journal of Plastic Surgery

Hong Ha N, Thanh Huyen TT (2025) · Acta Chirurgiae Plasticae

Baylan JM, Chambers JA, McMullin N, Fletcher JL, Sinha I, Lundy J, King BT, Chan RK (2015) · Burns