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Temporal artery biopsy technique

INTRODUCTION

Temporal artery biopsy is the primary modality for establishing a diagnosis of giant cell (temporal) arteritis. Giant cell arteritis is a chronic vasculitis affecting medium and large diameter arteries, predominantly in older individuals [1,2]. The aortic arch vessels and branches, and particularly branches of the external carotid artery, are most prominently affected [3]. The clinical manifestations result from inflammation of the affected arteries or from their gradual occlusion leading to signs of arterial ischemia [4,5].

The technical aspects of arterial biopsy by which to confirm a diagnosis of giant cell arteritis are reviewed here. The pathogenesis, clinical manifestations, diagnostic evaluation, and treatment of giant cell arteritis are reviewed elsewhere. (See "Pathogenesis of giant cell (temporal) arteritis" and "Clinical manifestations of giant cell (temporal) arteritis" and "Diagnosis of giant cell (temporal) arteritis" and "Treatment of giant cell (temporal) arteritis".)

INDICATIONS FOR BIOPSY

Temporal artery biopsy, which identifies the characteristic histopathology, remains the primary modality to diagnose giant cell (temporal) arteritis [6,7]. Other modalities used in the diagnosis of giant cell arteritis are discussed in detail elsewhere. (See "Diagnosis of giant cell (temporal) arteritis".)

The operating surgeon should be aware that the clinical manifestations of giant cell arteritis may overlap with those of polymyalgia rheumatica and both disease processes occur in similar patient populations [3]. If there is any question regarding the need for biopsy, the operating surgeon should consult the referring physician. The clinical manifestations of giant cell (temporal) arteritis are reviewed elsewhere. (See "Clinical manifestations of giant cell (temporal) arteritis".)

Temporal artery biopsy is generally a straightforward procedure typically performed using local anesthetic with few complications. As such, there are no absolute contraindications.

                           

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Literature review current through: Sep 2014. | This topic last updated: Sep 17, 2012.
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