Capillary refill test--a possible auxiliary diagnostic method in obliterative arteriosclerosis

Area of Science:

• Vascular Medicine
• Dermatology
• Medical Diagnostics

Background:

• Arteriosclerotic disease significantly impairs lower extremity microcirculation.
• Assessing the severity of peripheral arterial disease is crucial for treatment decisions.

Purpose of the Study:

• To evaluate the utility of capillary refill time (CRT) and capillary refill index (CRI) in assessing lower extremity microcirculation in patients with arteriosclerotic disease.
• To establish pathological thresholds for CRI and correlate it with disease severity and treatment outcomes.

Main Methods:

• Measured CRT in 133 lower extremities of arteriosclerotic patients and 84 of healthy controls.
• Calculated CRI based on CRT measurements and defined pathological values (<0.80).
• Correlated CRI with ankle/arm Doppler index (AAI), walking distance, rest pain, and assessed changes post-surgery.

Main Results:

• CRI values below 0.80 were considered pathological.
• Significantly lower CRI values were observed in advanced arteriosclerotic disease (p < 0.01).
• A positive correlation (r=0.50) was found between AAI, walking distance, and CRI. Extremely low CRI (<0.55) indicated severe ischemia.
• Post-surgical treatment led to a significant increase in CRI (p < 0.01).

Conclusions:

• CRI is a valuable, non-invasive tool for evaluating microcirculatory dysfunction in arteriosclerotic lower extremities.
• CRI effectively reflects disease severity and predicts response to surgical intervention.
• A CRI threshold of 0.80 can identify pathological microcirculation in this patient group.