Role of the toe-brachial index in assessing the patient’s clinical status

Although the term "target organ damage" is used primarily in relation to the diagnosis of hypertension, the fact that vessels are involved in a wider range of diseases is beyond doubt. Over the past 30 years, arterial stiffness has moved from the area of scientific interest to clinical guidelines. The ankle-brachial index is widely used to assess target organ damage. In a number of conditions (diabetes, chronic kidney disease, especially in the end-stage renal failure and hemodialysis), severe medial calcification of the arterial walls develops. As a result, the arteries become non-compressible, which leads to falsely elevated ankle-brachial index (>1,4). Toe vessels are less susceptible to vascular stiffness, which makes the toe-brachial index an accessible alternative in such a situation. The literature review highlights the history of toe-brachial index development as a research method, as well as the predictive value and prospects for further application. Its use offers opportunities for deepening and expanding understanding of the pathogenesis of a wide range of diseases, searching for and testing correction methods and developing effective prevention methods.