With the total removal of spell vamp from items and runes, now is the time to rework mage sustain.

The 2% spell vamp from masteries simply isn't enough for some builds. I'd hate to see a lot of unique playstyles disappear because of the removal of runes. Yes gunblade and DD provide an artificial spell vamp, but those are hybrid and full AD items. Now jungling as Karthus is going to be impossible. Sustaining in lane as a mage that doesn't build RoA or have innate healing simply doesn't exist. It's a huge weakness in solo lane mages, even support mages such as Janna have better sustain with Crucible and health regen items.

Vladimir's rework should have fixed the main issue with spell vamp, Vladimir. Most mages deal aoe damage so spell vamp isn't even that effective when it is an option. If you're not going to bring back spell vamp into the game, even in an extremely small amount such as 5% spell vamp tacked onto an item, mage sustain needs to be reworked entirely. RoA is a good start but it's simply not enough for the entire mage roster and coincidentally most of the RoA users are the few mages that already have innate sustain.