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This library indexes the full evidence base. For orientation, begin with the core guides:

What is hirudotherapy?Conditions atlas Clinical evidence Patient guide

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Evidence level

All FDA-cleared context Systematic review Randomized controlled trial Cohort / case series Case report Preclinical In vitro Mechanistic

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Showing 16 of 755 entries. Refine via URL query params.

Conditions

Knee Osteoarthritis

Tier B

Off-label use; several small RCTs in knee OA report pain and function improvement with leeches versus NSAID gel, sham leech or TENS, though results against sham and TENS are mixed, and a 2022 trial against physiotherapy found no therapeutic effect.

Studied off-labelSystematic review

Compounds

Hirudin Novel Drug Delivery Systems (NDDS)

Systematic review of hirudin novel drug delivery systems addressing the bioavailability + protease-degradation bottleneck — Mo 2024.

Preclinical / mechanisticSystematic review

RCTs

Current concepts in salvage procedures for failing microvascular flaps: is there a superior technique? Insights from a systematic review of the literature

GRADE low

Troeltzsch M, Troeltzsch M, Probst FA, Ristow O, Ehrenfeld M, Otto S (2016) · International Journal of Oral and Maxillofacial Surgery

Systematic review

The efficacy of arterial only microsurgical nasal replantation: a systematic review

GRADE low

Secanho MS, Rajaram R, de Menezes Neto BF, Cavale N, Ng SK, Neto AAP (2024) · ANZ Journal of Surgery

Systematic review

Leeches and hand surgery: history, physiology, and a scoping review

GRADE low

Chabridon AI, Coquerel-Beghin D, Leger M, Baamir A, Bazeli A, Auquit-Auckbur I (2026) · Hand Surgery and Rehabilitation

Systematic review

Applications of leech therapy in medicine: a systematic review

GRADE low

Hosseini M, Jadidi A, Derakhshan Barjoei MM, Salehi M (2024) · Frontiers in Medicine

Systematic review

The Use of Medicinal Leeching in Breast Surgery: A Systematic Review

GRADE low

Rajaram R, Cevik J, Bhindi N, Seth I, Rozen WM (2024) · Journal of Clinical Medicine

Systematic review

A Systematic Review of Complementary and Alternative Veterinary Medicine: Miscellaneous Therapies

GRADE low

Bergh A, Lund I, Boström A, Hyytiäinen H, Asplund K (2021) · Animals

Systematic review

Heparin and Bivalirudin in Percutaneous Coronary Intervention for Acute Coronary Syndromes: A Review Article

GRADE moderate

Wang G, Qi K, Li X, Zuo S, Zhang R, Zhao Y, Sun S, Zhang J, Liu X (2024) · Cardiovascular Therapeutics

Systematic review

Bivalirudin versus heparin anticoagulation in patients receiving extracorporeal membrane oxygenation

GRADE low

Huang D, Guan Q, Qin J, Shan R, Wu J, Zhang C (2022) · Perfusion

Systematic review

Heparin-based versus bivalirudin-based anticoagulation in pediatric extracorporeal membrane oxygenation: A systematic review

GRADE low

Valdes CA, Sharaf OM, Bleiweis MS, Jacobs JP, Mumtaz M, Sharaf RM, Jeng EI, Peek GJ (2023) · Frontiers in Medicine

Systematic review

Comparison of Bivalirudin Versus Heparin for Anticoagulation During Extracorporeal Membrane Oxygenation

GRADE low

Hasegawa D, Sato R, Prasitlumkum N, Nishida K, Keaton B, Acquah SO, Im Lee Y (2022) · ASAIO Journal

Systematic review

Heparin Versus Bivalirudin for Anticoagulation in Adult Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis

GRADE low

Wieruszewski PM, Macielak SA, Nei SD, Moman RN, Seelhammer TG, Nabzdyk CGS, Gerberi DJ, Mara KC, Hooten WM, Wittwer ED (2022) · ASAIO Journal

Systematic review

Is bivalirudin an alternative anticoagulant for extracorporeal membrane oxygenation (ECMO) patients? A systematic review and meta-analysis

GRADE low

Li DH, Sun MW, Zhang JC, Zhang C, Deng L, Jiang H (2021) · Thrombosis Research

Systematic review

Penile Replantation: A Review of Microsurgical Techniques, Patient Outcomes, and Solutions to Complex Reconstructive Challenges

GRADE low

Arbel EJ, Reese AD, Richards R, Singh S, O'Shea AW, Hennig F, Abramowitz D (2024) · Plastic Surgery (Oakville)

Systematic review

Medicinal Leech Therapy in Urology: A PRISMA-Compliant Systematic Review

GRADE low

Battin AO, Hobeika N, Zdilla MJ (2023) · African Journal of Urology

Systematic review