Introduction: Chronic limb ischemia (CLI) and diabetic foot significantly impact patients’ quality of life, with high rates of amputation and mortality. Angiosome-oriented revascularization represents an anatomically precise approach, targeting the artery that directly supplies the lesion area. Direct revascularization (DR) is increasingly considered superior to indirect revascularization (IR) due to potentially better wound healing and limb salvage outcomes. Methods: A narrative literature review was conducted using PubMed, Cochrane Library, and Google Scholar, with the keywords: angiosome, critical limb ischemia, diabetic foot, direct revascularization, endovascular, bypass surgery. Studies published between 2020 and 2025 were included, focusing on systematic reviews, meta-analyses, and prospective cohort and clinical studies. In addition to clinical studies, anatomical data on the distribution of foot and lower leg angiosomes were analyzed, including a table illustrating the correlation between wound location and target artery. Results: Six main angiosomes of the lower limb were identified, each corresponding to a specific artery. DR was associated with higher rates of wound healing and limb preservation, reducing the risk of amputation by 20–30% compared to IR. Optimal candidates for DR are those with localized lesions, patent distal target arteries, and adequate microcirculation. DR is less effective or technically unfeasible in patients with diffuse microvascular disease, multisegment occlusions, poor distal vessels, or active severe infections. Advanced technologies such as hyperspectral imaging and indocyanine green (ICG) mapping improve intraoperative perfusion assessment. Conclusion: Angiosome-oriented revascularization is a logical and anatomically grounded approach for treating CLI and diabetic foot. When feasible, DR of the target artery provides better clinical outcomes than IR. Success requires precise diagnostics, patient selection, and multidisciplinary collaboration. Further randomized studies are needed to define optimal application algorithms for this concept.

Introduction: Pseudoaneurysm (PSA) is defined as a defect in the arterial wall at the puncture site, leading to an extraluminal blood collection surrounded by fibrous tissue, and represents the most common vascular complication after coronary angiography. The aim of this study was to identify risk factors for PSA development after coronary interventions and to define criteria for surgical treatment. Materials and Methods: A retrospective analysis was conducted on 32 patients treated at CHC Zemun over a ten-year period (2012–2022). During the observed period, 16,787 coronary procedures were performed (10,498 coronary angiographies, 6,289 PCIs). The study group included 17 patients with PSA, and 15 patients in the control group with a hematoma that did not progress to PSA. Demographic data, comorbidities, laboratory parameters, therapy, smoking habits, procedural details, and PSA characteristics were recorded, with comparison between surgically and conservatively treated patients. Results: The mean time to PSA diagnosis was 3.29 ± 4.7 days, whereas hematomas were diagnosed within 24 hours. No significant differences in sex or age were observed between groups. More than half of the patients had hypertension, hyperlipidemia, and chronic cardiac or renal diseases. Low hemoglobin, thrombocytopenia, and INR >3 were identified as independent risk factors. Most interventions were performed via the right femoral artery, with PSA most commonly located in the common femoral artery. Median PSA diameter was 44 mm in surgically treated patients and 19 mm in conservatively treated patients. No deaths occurred; the most common postoperative complication was residual hematoma. Conclusion: The first 72 hours after intervention represent the most critical period for PSA detection. PSA diameter is a key factor in therapy selection, lesions >2 cm and complicated ones require surgical intervention, while smaller lesions can be treated conservatively. Timely diagnosis and treatment improve outcomes, and our findings may help optimize patient monitoring protocols and early surgical intervention selection.