Biblioteca Inteligente

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

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

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

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

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

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

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.

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

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 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.