Patterns of Angiographic Remodeling Following Foot Vein Arterialization

Vascular remodeling after FVA is a complex process involving multiple pathophysiological mechanisms, resulting in various angiographic patterns. Recognizing these patterns may aid clinicians in developing targeted treatments to enhance FVA efficacy and improve clinical outcomes.Clinical ImpactThis study introduces the first classification of angiographic patterns of vascular remodeling following foot vein arterialization (FVA), addressing the significant unpredictability of clinical outcomes despite high technical success in no-option CLTI patients. The primary clinical impact is providing a standardized framework to monitor and interpret the complex FVA maturation process. By recognizing the temporal evolution of these distinct patterns, clinicians can identify patients with suboptimal remodeling. This allows for targeted secondary interventions to guide vascular pathways, enhance tissue perfusion, and ultimately improve rates of wound healing and limb salvage, laying the groundwork for optimizing this limb-saving therapy.