Theory: Sustain Items

I am remiss for taking so long to continue the sustain series, but at last I have compiled my thoughts on sustain items.

Sustain items differ from runes in that they lack purity of purpose. While most items only feature one type of sustain, they come with a plethora of other stats that complicate comparisons between them. Choosing sustain items is as much about their other benefits as it about the sustain itself.

Thankfully the various sustain items largely play to the strengths of their sustain type. Hp5 items tend to be focused on defenses because they scale well off each other. Life Steal items always feature attributes which benefit auto-attacking. Spell Vamp items generally feature AP as most champions interested in Spell Vamp have significant AP ratios. While certain choices will often be highly situational, few sustain items are completely useless.

Even though champions tend to clearly favor a specific sustain type, the diversity in what sustain items offer can make choosing between them difficult. As such, here are my thoughts on the major sustain items:

Hp5:

• Philosopher's Stone: A strong sustain item while laning, it turns into the excellent Shurelya's Reverie later in the game. It is likely the most common sustain item in the game. Later in the game it loses effectiveness due to its lack of defensive stats and the overwhelming damage that begins to surface.
• Doran's Shield: Extremely efficient for its cost, this is a good purchase for a harried champion needing a quick mix of defense and safe sustain. It's not a particularly good buy when you aren't at a disadvantage.
• Warmog's Armor: Bought more for its health than its Hp5, and rarely early. While 40 Hp5 is a lot, it pales in comparison to the damage being thrown around. It makes a big difference, however, when the enemy AP carry is out of mana or when another tanky champion is trying to take you down. It has very strong synergy with Force of Nature.
• Force of Nature: Easily provides 60-100 Hp5, depending on your health. Rarely an early buy as it is fairly weak without health, but later in the game it can make tanky champions seem unkillable. Combined with Warmog's you can often exit a teamfight within an inch of death only to return with enough health to clean up at the end.
• Randuin's Omen/Warden's Mail: Few remember that these items even have Hp5. Both are extremely effective for sustaining against AD opponents top lane due to the combination of armor, Hp5, and the passive proc, with bonus health and an active on Randuin's. That Randuin's is also the single best defense against AD carries is a big bonus.
• Locket of the Iron Solari/Emblem of Valor: Essentially a weaker Randuin's. Despite being designed for supports it is rarely bought during the laning phase due to its cost. It isn't a bad purchase later in the game for its active, but ultimately it's a fairly weak sustain item.

 Life Steal:

• Wriggle's Lantern: One of the most cost-efficient items in the game, and easily the second most common sustain item. However, it offers exactly the same sustain as a simple Vampiric Scepter. Because of this it's rarely bought as a second or third item as you're better off building something stronger.
• Doran's Blade: A very common buy for easier last hitting and a little sustain. A couple Doran's Blades provide nearly the same AD as Wriggle's Lantern for roughly half the cost, but at the same time only provide half the sustain. AD carries often prefer a couple of these to Wriggle's; they are effective immediately and help the AD carry rush toward their important items.
• Bloodthirster: Most commonly seen on specific AD carries or very fed bruisers with good AD scaling. The offensive potential of this item is unparalleled by any other Life Steal item. It is also expensive, and loses effectiveness if you frequently die.
• Executioner's Calling: A rare purchase, but extremely potent in lane because it combines sustain with anti-sustain. Many players underestimate the effectiveness of a pseudo-ignite on a 20 second cooldown. It's also a good item to have late-game against burst healing.
• Zeke's Herald: Typically purchased to give someone else sustain, this is a common mid-late game item and rarely seen during laning. Like many other aura items Zeke's is heavily undervalued by the community.
  
• Hextech Gunblade/Bilgewater Cutlass: Unfortunately, Hextech Gunblade gives exactly the same Life Steal as Bilgewater Cutlass, and only five more AD. Any champions interested primarily in Life Steal have little or no reason to upgrade to Gunblade. The lack of an upgrade path generally deters most from building Cutlass.

Spell Vamp:

• Hextech Revolver: A very cheap and efficient source of Spell Vamp, if you can make use of the AP. This is a very common buy on any AP bruiser or manaless AP champion.
• Will of the Ancients: The team oriented upgrade to Hextech Revolver. The personal benefit is somewhat limited, so most champions will hold onto Revolver until team fighting begins in earnest.
• Hextech Gunblade: The highly situational hybrid upgrade to Revolver. Very few champions make good use of this item's mixed attributes. On those that do, however, it's a viable alternative to Will of the Ancients. Gunblade is generally either rushed or saved until last in item builds.

Miscellaneous:

• Spirit Visage: Notable because it increases the effectiveness of all three sustain types by 15%. However, this rarely translates to more than 1-2% Life Steal/Spell Vamp or more than 20 Hp5, even in the late stages of the game. Spirit Visage therefore isn't taken for sustain, but for its synergy with massive self-healing abilities.

You should notice immediately that Spell Vamp has the most limited itemization of all the sustain types. There's no basic Spell Vamp item, and only two finished items to consider. This reflects Spell Vamp's late entry into the game's itemization. All three current Spell Vamp items were added roughly 9 months after launch, and none have been added since. Perhaps more Spell Vamp items will be added in the future, but for now Spell Vamp is significantly harder to obtain than other sustain types.

For Life Steal and Hp5 the variety of choices allows them to be more easily incorporated into a build or role. While not endlessly flexible there's a reasonable option for almost any scenario. Even in the worst case there are cheap, basic items to provide that sustaining edge. Whatever the situation these two types of sustain are readily available.

You may not always buy sustain items, but the difference they can make in a matchup or teamfight is significant. Whether it's in the disorganized chaos of low Elos or the drawn out epic engagements in higher rankings, sustain is a critical factor. Item-centric compositions like double-WotA didn't emerge for no reason.

I've learned from my hubris and will not guarantee when the next and final installment in this series on sustain will come. If I decide to discuss the various types of sustain champions bring to the table in the same detail as I did items it could be some time. Either way, look forward to it.