Angiosome-directed revascularization for critical limb ischemia

The angiosome hypothesis states that the surface of the lower extremity is supplied by arteries consistently corresponding to regions of the foot. There is limited and conflicting evidence suggesting that angiosome-directed interventions improve wound healing and limb salvage. As peripheral arterial disease progresses, collaterals may develop that confound a predetermined angiosome map. In selecting a revascularization target vessel for patients with tissue loss, good surgical judgment should prevail, including consideration of the angiosome concept to optimize tissue healing.