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The review outlines how angiosome-based targeted revascularization aims to improve perfusion to ischemic wounds, while woundosome-based individualized targeting incorporates anatomic variation, collateral circulation, and wound characteristics. A systematic search (1990 to Feb 2025) identifies 14 included studies, synthesizing evidence on wound healing and limb salvage while highlighting methodological limitations.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-angiosome-and-woundosome-concepts-in-guiding-revascularization-for-chronic-limb-threatening-ischemia-and-diabetic-foot-ulcers-a-narrative-review/450336/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-angiosome-and-woundosome-concepts-in-guiding-revascularization-for-chronic-limb-threatening-ischemia-and-diabetic-foot-ulcers-a-narrative-review/450336.png","ImageObject",300,407,{"name":92,"@type":93},"Ophelia","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-02","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":14},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the angiosome concept and how does it guide revascularization?","Question",{"text":112,"@type":113},"The angiosome concept divides the body into three-dimensional tissue blocks supplied by specific source arteries, helping clinicians target revascularization to improve blood flow to ischemic wounds.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How does the woundosome concept differ from angiosome guidance?",{"text":117,"@type":113},"The woundosome concept focuses on individualized perfusion targeting based on anatomic variations, the presence and extent of collateral circulation, and wound characteristics.",{"name":119,"@type":110,"acceptedAnswer":120},"What outcomes does the review summarize for direct versus indirect revascularization?",{"text":121,"@type":113},"Most retrospective studies reported improved wound healing and limb salvage with angiosome-guided direct revascularization, especially when inline flow was restored. Comparable outcomes were observed for indirect revascularization when collateral circulation was robust.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},450336,1790949597,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":14,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},7971461741311,"https://ap-avatar.wpscdn.com/avatar/74000253aff267980c6?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779345379180704826","The angiosome and woundosome concepts in guiding revascularization for chronic limb-threatening ischemia and diabetic foot ulcers—a narrative review  \nTheodoros Moysidis1^, Lorenzo Patrone2, Dittmar Böckler3, Kathrin Niemöller1, Grigorios Korosoglou4,5  \n1Division of Internal Medicine V, Department of Angiology, Knappschaft Kliniken Westfalen, Dortmund, Germany; 2Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, Italy; 3Department of Vascular Surgery, University Hospital Heidelberg, Heidelberg, Germany; 4Department of Cardiology and Vascular Medicine, GRN Hospital Weinheim, Weinheim, Germany; 5Cardiovascular Imaging Center, Hector Foundation, Weinheim, Germany  \nContributions: (I) Conception and design: T Moysidis, G Korosoglou; (II) Administrative support: G Korosoglou; (III) Provision of study materials or patients: L Patrone; (IV) Collection and assembly of data: T Moysidis; (V) Data analysis and interpretation: T Moysidis, L Patrone, G Korosoglou; (VI)  \nManuscript writing: All authors; (VII) Final approval of manuscript: All authors.  \nCorrespondence to: Theodoros Moysidis, MD. Division of Internal Medicine V, Department of Angiology, Knappschaft Kliniken Westfalen, Am Knappschaftskrankenhaus 1, 44309 Dortmund, Germany. Email: [theodoros.moysidis@knappschaft-kliniken.de](theodoros.moysidis@knappschaft-kliniken.de); [t.moysidis@outlook.de](t.moysidis@outlook.de).  \nBackground and Objective: The angiosome concept, introduced by Taylor et al. and further applied by Neville et al., divides the body into three-dimensional blocks of tissue supplied by specific source arteries.  \nThis anatomical framework has been instrumental in guiding targeted revascularization strategies, thus enhancing blood flow to ischemic wounds. Building upon this, the woundosome concept was recently introduced, which focuses on individualized perfusion targeting, based on (I) anatomic variations; (II) the presence and extent of collateral circulation; and (III) wound characteristics. The woundosome concept may offer a potentially more tailored approach, paving the way for more thoughtful tissue revascularization. This review aims to investigate the role of angiosome-and woundosome-directed endovascular revascularization  \nfor the improvement of outcomes in patients with chronic limb-threatening ischemia (CLTI) .  \nMethods: We conducted a systematic search in PubMed, Web of Science, and Cochrane Library from 1990 to February 2025 using combinations of the terms “angiosome”,“woundosome”, “critical limb ischemia”,“diabetic foot ulcer”,“direct revascularization”, and “indirect revascularization”. After screening 480 records, 14 studies were included in our analysis. Data were extracted regarding study design, patient population, revascularization strategy, and outcomes (wound healing, limb salvage). Findings were narratively synthesized  \nwith respect to study methodology and limitations.  \nKey Content and Findings: Most retrospective studies reported improved wound healing and limb salvage rates following angiosome-guided direct revascularization (DR), particularly when inline flow could be restored. However, comparable outcomes were observed with indirect revascularization (IR) in the presence of robust collateral circulation. Evidence for woundosome-guided revascularization remains limited but suggests that a perfusion-oriented, individualized strategy may be especially valuable in anatomically  \ncomplex cases.  \nConclusions: Incorporating angiosome-and woundosome-based strategies in CLTI management may improve limb-and patient-related outcomes. The decision on which particular territory needs primary attention and how many vessels require revascularization largely depends on the patency of feeding arteries in the wound area. In the future, a standardized way to measure the intra-and post-procedural arterial flow to the wound would be necessary, to study the clinical applications of the mentioned strategies. Future studies ","cbCaicEh7cOP54RO","https://ap.wps.com/l/cbCaicEh7cOP54RO","pdf",2872550,15,"English","# Introduction\n## Objectives\n# Methods\n## Search strategy and study selection\n## Data extraction and synthesis\n# Key content and findings\n# Conclusions","[{\"question\":\"What is the angiosome concept and how does it guide revascularization?\",\"answer\":\"The angiosome concept divides the body into three-dimensional tissue blocks supplied by specific source arteries, helping clinicians target revascularization to improve blood flow to ischemic wounds.\"},{\"question\":\"How does the woundosome concept differ from angiosome guidance?\",\"answer\":\"The woundosome concept focuses on individualized perfusion targeting based on anatomic variations, the presence and extent of collateral circulation, and wound characteristics.\"},{\"question\":\"What outcomes does the review summarize for direct versus indirect revascularization?\",\"answer\":\"Most retrospective studies reported improved wound healing and limb salvage with angiosome-guided direct revascularization, especially when inline flow was restored. Comparable outcomes were observed for indirect revascularization when collateral circulation was robust.\"}]","The angiosome and woundosome concepts in guiding revascularization for chronic limb-threatening ischemia and diabetic foot ulcers - a narrative review | PDF",1790732920,38]