Interrogating vascular determinants of repair: Biofabricated constructs for precision intervention in peripheral neuropathies

Peripheral neuropathies (PN) exact a devastating global toll, manifest across traumatic and non-traumatic spectra and culminating in intractable pain, sensorimotor impairment, and chronic disablement. Converging upon a shared pathological crux, these conditions implicate destabilization of the neurovascular niche, a derangement that impairs perfusion, metabolic supply, and axonal pathfinding signals. Vascular dysfunction thus constitutes a unifying therapeutic lever. Synthesizing clinical, bibliometric, and single-cell transcriptomic evidence, this review delineates neurovascular crosstalk as instrumental to both disease progression and regenerative capacity. Advanced biomaterial-enabled, vascular-guided engineering platforms, refined through contemporary fabrication technologies, present incisive interventions to surmount this barrier. Therapeutic strategies are demarcated by PN subtype, while modifications aimed at promoting concurrent angiogenesis and neural repair receive exhaustive exposition. Prevailing evidence consolidates in advocacy of a vasculocentric framework. Translational impediments and emergent prospects are surveyed to accelerate clinical fruition.