Accurate vessel segmentation is essential for diagnosing and managing vascular and ophthalmic diseases. Traditional learning-based vessel segmentation methods heavily rely on high-quality, pixel-level annotated datasets. However, segmentation performance suffers significantly when applied in federated learning settings due to vessel morphology inconsistency and vessel-background imbalance. The former limits the ability of models to capture fine-grained vessels, while the latter overemphasizes background pixels and biases the model towards them. To address these challenges, we propose a novel method named Federated Vessel-Aware Calibration (FVAC), which leverages global uncertainty to provide differentiated guidance for clients, focusing on pixels of various morphologies that are difficult to distinguish. Furthermore, we introduce a foreground-background decoupling alignment strategy that utilizes more stable and balanced global features to mitigate semantic drift caused by vessel-background imbalance in local clients. Comprehensive experiments confirm the effectiveness of our method