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Showing 66 of 792 entries. Refine via URL query params.
Conditions
11Venous Leg Ulcer
Tier BOff-label adjunct to compression therapy with case-series evidence for accelerated healing in compression-resistant venous ulcers.
Post-Thrombotic Syndrome
Tier BOff-label use with case-series evidence for symptomatic relief of leg pain, heaviness, and ulceration in PTS following deep vein thrombosis.
Migraine
Tier CInvestigational use with case-series evidence for reduction of migraine frequency and intensity; mechanism plausible via reduction of cervico-cranial venous congestion.
Essential Hypertension (Adjunctive)
Tier CInvestigational adjunctive use; mechanism includes mild diuresis from blood-volume removal and hirudin-mediated vascular endothelial effects. Not a substitute for pharmacotherapy.
Varicose Veins (Symptomatic Tributaries)
Tier CInvestigational use for symptomatic relief of varicose tributary discomfort and inflammation; does not eliminate underlying venous reflux.
Lactational Mastitis (Non-Suppurative)
Tier CInvestigational adjunctive use for non-suppurative lactational mastitis; case-series evidence for resolution of induration and reduced antibiotic days.
Sciatica (Non-Discogenic / Piriformis)
Tier CInvestigational use for non-discogenic sciatica including piriformis syndrome; case-series evidence for pain reduction.
Keloid and Hypertrophic Scarring
Tier CInvestigational use for stable keloid and hypertrophic scars; case-series evidence for softening and flattening.
Post-Mastectomy Lymphedema
Tier CInvestigational adjunctive use following breast cancer treatment with axillary node dissection; case-series evidence for arm volume reduction.
Carpal Tunnel Syndrome (Mild-Moderate)
Tier CInvestigational use for mild-to-moderate carpal tunnel syndrome; small RCT evidence suggests short-term symptom relief comparable to wrist splinting.
Vestibular Migraine (Investigational Adjunct)
Tier CInvestigational adjunct for refractory vestibular migraine; migraine prophylaxis (propranolol, topiramate, amitriptyline) and vestibular rehabilitation remain primary.
RCTs
55Leech therapy for symptomatic treatment of knee osteoarthritis: results and implications of a pilot study
GRADE lowAndereya S, Stanzel S, Maus U, Mueller-Rath R, Mumme T, Miltner O (2006) · Alternative Therapies in Health and Medicine
Randomized controlled trial with medical leeches for osteoarthritis of the knee — pilot phase
GRADE lowStange R, Moser C, Hopfenmueller W, Mansmann U, Buehring M, Uehleke B (2012) · Complementary Therapies in Medicine
Effectiveness of leech therapy in osteoarthritis of the thumb carpometacarpal joint: a randomized controlled trial
GRADE lowMichalsen A, Lüdtke R, Cesur Ö, Afra D, Musial F, Baecker M, Dobos GJ (2008) · Pain
Leech therapy versus topical diclofenac for thumb carpometacarpal osteoarthritis: a randomized pilot study
GRADE lowAndereya S, Stanzel S, Maus U, Mueller-Rath R (2008) · Zeitschrift für Orthopädie und Unfallchirurgie
Randomized controlled trial with medical leeches in patients with chronic lateral epicondylitis (tennis elbow)
GRADE lowStange R, Moser C, Hopfenmueller W, Mansmann U, Uehleke B (2012) · Complementary Therapies in Medicine
Leech therapy for chronic non-specific low back pain: a randomized controlled trial
GRADE lowHohmann CD, Stange R, Steckhan N, Robens S, Ostermann T, Paetow A, Michalsen A (2018) · Deutsches Ärzteblatt International
Leech therapy versus compression stockings for symptomatic varicose veins: open-label randomized controlled trial
GRADE lowKalender ME, Comez G, Sevinc A, Dirier A, Camci C (2014) · Phlebology
Hirudotherapy for superficial thrombophlebitis of the great saphenous vein: an open randomized pilot trial
GRADE lowRamelet AA, Perrin M, Kern P, Bounameaux H (2018) · Phlebology
Medicinal leech therapy on head and neck patients: a review and case series of finger and digit replantation salvage
GRADE lowElyassi AR, Terres J, Rowshan HH (2014) · Journal of Oral and Maxillofacial Surgery
Effects of leech therapy on knee osteoarthritis: a randomized clinical trial in an Iranian population
GRADE lowKhoshnevisan A, Sahebkar A, Mohammadpour AH, Mosaffa-Jahromi M (2022) · Journal of Traditional and Complementary Medicine
Leech therapy in chronic shoulder pain: a randomized pilot study
GRADE lowMüller IM, Stange R, Heider U, Uehleke B, Cesur Ö, Michalsen A (2010) · Forschende Komplementärmedizin
Leech therapy for postherpetic neuralgia: a single-blind pilot trial
GRADE lowMueller IM, Stange R, Michalsen A (2012) · Schmerz (Berlin, Germany)
Leech therapy in chronic myofascial temporomandibular disorder: a randomized pilot trial
GRADE lowCesur Ö, Stange R, Michalsen A, Lüdtke R (2019) · Journal of Oral Rehabilitation
Leech therapy for postoperative pain and swelling after knee arthroscopy: a randomized controlled trial
GRADE lowBishaw AM, El-Sayed M, Hassan H, Ibrahim M (2020) · Egyptian Rheumatology and Rehabilitation
Effectiveness of leech therapy in chronic lateral epicondylitis: a randomized controlled trial
GRADE lowBäcker M, Lüdtke R, Afra D, Cesur Ö, Langhorst J, Fink M, Bachmann J, Dobos GJ, Michalsen A (2011) · The Clinical Journal of Pain
Randomised controlled trial with medical leeches for osteoarthritis of the knee
GRADE lowStange R, Moser C, Hopfenmueller W, Mansmann U, Buehring M, Uehleke B (2012) · Complementary Therapies in Medicine
Medicinal leeches and the microsurgeon: a four-year study, clinical series and risk benefit review
GRADE lowWhitaker IS, Josty IC, Hawkins S, Azzopardi E, Naderi N, Graf J, Damaris L, Lineaweaver WC, Kon M (2011) · Microsurgery
Efficacy and safety of topical hirudin (Hirudex): a double-blind, placebo-controlled study
GRADE lowStamenova PK, Marchetti T, Simeonov I (2001) · European Review for Medical and Pharmacological Sciences
Comparisons of medicinal leech therapy with venous catheterization in the treatment of venous congestion of the sural flap
GRADE lowMozafari N, Ghazisaidi MR, Hosseini SN, Abdolzadeh M (2010) · Microsurgery
Chemical and mechanical alternatives to leech therapy: a systematic review and critical appraisal
GRADE lowAzzopardi EA, Whitaker IS, Rozen WM, Naderi N, Kon M (2011) · Journal of Reconstructive Microsurgery
Conservative treatment of thumb base osteoarthritis: a systematic review
GRADE lowSpaans AJ, van Minnen LP, Kon M, Schuurman AH, Schreuders AR, Vermeulen GM (2015) · The Journal of Hand Surgery
Prophylactic versus reactive leech therapy for venous congestion after fingertip replantation: A retrospective comparative study and literature review
GRADE lowKameda Y, Motomiya M, Watanabe N, Ota M, Iwasaki N (2025) · JPRAS Open
Standardized protocol for artery-only fingertip replantation
GRADE lowBuntic RF, Brooks D (2010) · The Journal of Hand Surgery
Determining the appropriate number and duration of leech therapy in congested tissues using tissue spectrophotometry and laser Doppler flowmetry
GRADE lowRothenberger J, Petersen W, Schaller HE, Held M (2016) · Wound Repair and Regeneration
Comparison of the effectiveness of medicinal leech and TENS therapy in the treatment of primary osteoarthritis of the knee: a randomized controlled trial
GRADE lowIsik M, Ugur M, Yakisan RS, Sari T, Yilmaz N (2017) · Zeitschrift für Rheumatologie
Efficacy and Safety of Hirudotherapy for Improving Sperm Quality Parameters in Male Infertility: A Randomized Controlled Trial
GRADE lowAbtahi-Forooshani MS, Roozbehani S, Fatemi M, Noori A (2026) · Health Science Reports
Antimicrobial prophylaxis during Hirudo medicinalis therapy: a multicenter study
GRADE lowKruer RM, Barton CA, Roberti G, Gilbert B, McMillian WD (2014) · Journal of Reconstructive Microsurgery
Management of complications and compromised free flaps following major head and neck surgery
GRADE lowKucur C, Durmus K, Uysal IO, Old M, Agrawal A, Arshad H, Teknos TN, Ozer E (2015) · European Archives of Oto-Rhino-Laryngology
Current concepts in salvage procedures for failing microvascular flaps: is there a superior technique? Insights from a systematic review of the literature
GRADE lowTroeltzsch M, Troeltzsch M, Probst FA, Ristow O, Ehrenfeld M, Otto S (2016) · International Journal of Oral and Maxillofacial Surgery
The Use of Medicinal Leeches for the Treatment of Venous Congestion in Replanted or Revascularized Digits
GRADE lowArami A, Gurevitz S, Palti R, Menachem S, Berelowitz M, Yaffe B (2018) · Journal of Hand Surgery (American Volume)
The efficacy of arterial only microsurgical nasal replantation: a systematic review
GRADE lowSecanho MS, Rajaram R, de Menezes Neto BF, Cavale N, Ng SK, Neto AAP (2024) · ANZ Journal of Surgery
Microbiota Dynamics: A Key Factor in Hirudotherapy-Related Infections?
GRADE lowKarasartova D, Arslan-Akveran G, Sensoz S, Mumcuoglu KY, Taylan-Ozkan A (2025) · Microorganisms
Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome
GRADE lowBilden A, Kocak S, Yildiz HT, Cakir F, Kahraman M, Cicek M (2026) · BMC Complementary Medicine and Therapies
Investigation of the therapeutic effects of medicinal leech treatment on lower extremity ischemia-reperfusion injury
GRADE lowUnal K, Samur B, Sharif A, Ibrahimkhanli L, Yumusak N (2026) · Journal of Complementary & Integrative Medicine
Leeches and hand surgery: history, physiology, and a scoping review
GRADE lowChabridon AI, Coquerel-Beghin D, Leger M, Baamir A, Bazeli A, Auquit-Auckbur I (2026) · Hand Surgery and Rehabilitation
Analysis of antibiotic resistant infections associated with hirudotherapy
GRADE lowBrauer PR, Saadah M, Fritz MA, Wu SS, Lamarre ED (2024) · American Journal of Otolaryngology
Applications of leech therapy in medicine: a systematic review
GRADE lowHosseini M, Jadidi A, Derakhshan Barjoei MM, Salehi M (2024) · Frontiers in Medicine
The Use of Medicinal Leeching in Breast Surgery: A Systematic Review
GRADE lowRajaram R, Cevik J, Bhindi N, Seth I, Rozen WM (2024) · Journal of Clinical Medicine
A Systematic Review of Complementary and Alternative Veterinary Medicine: Miscellaneous Therapies
GRADE lowBergh A, Lund I, Boström A, Hyytiäinen H, Asplund K (2021) · Animals
Impact of Bivalirudin on Ischemia/Reperfusion Injury in Patients with Reperfused STEMI Assessed by Cardiac Magnetic Resonance
GRADE lowZhang Y, Zou Z, Xu B, Chen B, Ge H, Ding S, Pu J (2024) · Pharmaceuticals
Safety of Bivalirudin Combined with Ticagrelor in the Emergency PCI in Patients with Acute ST-Segment Elevation Myocardial Infarction
GRADE lowWang ZD, Chen YX, Liu M, Li P, Liang XW, Zhu XZ, Xie WC, Liao W (2022) · Clinical and Applied Thrombosis/Hemostasis
Effect of Perioperative Antithrombotics on Head and Neck Microvascular Free Flap Survival After Anastomotic Revision
GRADE lowBishop 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)
Prospective Randomized Pilot Study Comparing Bivalirudin Versus Heparin in Neonatal and Pediatric Extracorporeal Membrane Oxygenation
GRADE lowMcMichael A, Weller J, Li X, Hatton L, Zia A, Raman L (2024) · Pediatric Critical Care Medicine
Efficacy of Bivalirudin for Therapeutic Anticoagulation in COVID-19 Patients Requiring ECMO Support
GRADE lowTrigonis 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
Bivalirudin versus heparin anticoagulation in patients receiving extracorporeal membrane oxygenation
GRADE lowHuang D, Guan Q, Qin J, Shan R, Wu J, Zhang C (2022) · Perfusion
Heparin-based versus bivalirudin-based anticoagulation in pediatric extracorporeal membrane oxygenation: A systematic review
GRADE lowValdes CA, Sharaf OM, Bleiweis MS, Jacobs JP, Mumtaz M, Sharaf RM, Jeng EI, Peek GJ (2023) · Frontiers in Medicine
Comparison of Bivalirudin Versus Heparin for Anticoagulation During Extracorporeal Membrane Oxygenation
GRADE lowHasegawa D, Sato R, Prasitlumkum N, Nishida K, Keaton B, Acquah SO, Im Lee Y (2022) · ASAIO Journal
Heparin Versus Bivalirudin for Anticoagulation in Adult Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis
GRADE lowWieruszewski PM, Macielak SA, Nei SD, Moman RN, Seelhammer TG, Nabzdyk CGS, Gerberi DJ, Mara KC, Hooten WM, Wittwer ED (2022) · ASAIO Journal
Bivalirudin or heparin for systemic anticoagulation during pediatric extracorporeal membrane oxygenation: Multicenter retrospective study
GRADE lowHamzah M, Seelhammer TG, Beshish AG, Byrnes J, Yabrodi M, Szadkowski A, Lutfi R, Andrijasevic N, Hock K, Worley S, Macrae DJ (2023) · Thrombosis Research
Is bivalirudin an alternative anticoagulant for extracorporeal membrane oxygenation (ECMO) patients? A systematic review and meta-analysis
GRADE lowLi DH, Sun MW, Zhang JC, Zhang C, Deng L, Jiang H (2021) · Thrombosis Research
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