Description of a Temporal Artery Biopsy
A temporal artery biopsy is a medical test in which a health care provider extracts a small sample of tissue from the temporal artery for examination under a microscope for damage and inflammation.
Arteries are blood vessels that carry blood away from the heart to the rest of the body.
Temporal arteries are located in the temples (the region on the side of the head, between the ears and eyes).
Reasons for a Temporal Artery Biopsy
When a doctor suspects a patient may have temporal arteritis, he or she will likely suggest a temporal artery biopsy. Temporal arteritis is also known as giant cell arteritis or cranial arteritis. It is a swelling of the temporal artery lining and typically produces a headache or pain in the temples. It can also cause fever, jaw pain when chewing, and vision problems. Other conditions can cause these symptoms, so performing a temporal artery biopsy will aid a health care provider in the diagnosis process.
Preparing for a Temporal Artery Biopsy
Inform Your Health Care Provider Of:
- All medications being taken including: Herbs, eye drops, steroids (by mouth or creams), blood thinners (anticoagulants), aspirin, all over-the-counter drugs and creams, and any other drugs that might affect blood clotting
- Pregnancy possibility
- History of blood clots, bleeding, or other blood problems
- Past surgeries
- Smoking history
- Other health problems
Before a temporal artery biopsy a health care provider will perform a medical evaluation that may involve:
Physical Exam: The health care provider will check the temples, which may feel swollen and hard. The health care provider may be incapable of feeling a pulse (blood flowing through the artery as the heart beats).
Blood Tests: Typically a health care provider will order a test that measures how well the blood clots (lumps together to stop bleeding). Another test called a sed rate test evaluates erythrocyte sedimentation (how quickly red blood cells move to the bottom of a test tube). Cells that move to the bottom quickly indicate inflammation in the body. Nearly all patients with temporal arteritis have a high sed rate.
Speaking to an anesthesiologist: This is the physician who controls the anesthesia (medication) during the procedure. For a temporal artery biopsy, local anesthesia is typically used, which means the area of the temples will be numbed (no feeling), and the patient will be awake but groggy during the procedure.
The patient must provide informed consent, which means he or she will sign a legal document:
- Authorizing the procedure.
- Confirming they understand how and why the procedure is being performed.
- Confirming they have been informed of all benefits and risks associated with the procedure.
In certain circumstances, a legal guardian my sign the consent, and the signing should always be witnessed by a healthcare professional.
On the day of the procedure, the patient should arrive an hour early or whenever the health care provider suggests.
A temporal artery biopsy is usually an outpatient procedure, meaning the patient returns home the day of the biopsy and will need to make arrangements to be driven home.
What to Expect During a Temporal Artery Biopsy
Before the Temporal Artery Biopsy Procedure:
The patient will first change into a hospital gown and be taken to the room where the biopsy will be performed.
Monitors that check the heart, blood pressure, and oxygen level will be placed on the patient’s body.
An IV will be administered, which means a needle will be put in the arm for medication to flow straight into the body through the needle.
The surgeon will locate the temporal artery. A pencil-like instrument called a doppler might be used to pinpoint the artery. The doppler uses sound waves to find the artery, which allows the healthcare provider to trace the path of the artery on the temple and mark the skin for the procedure.
The site of the biopsy will be sterilized with a germ killing solution, and then the patient will be injected (shot) with local anesthetic in one or several spots. Sometimes a numbing cream is rubbed on the skin of the biopsy site before the local anesthetic is administered.
A sedative will be given to the patient, which causes drowsiness and helps the patient relax.
Temporal Artery Biopsy Procedure:
- Typically a temporal artery biopsy takes around 30 minutes.
- A small incision (cut) around 2-3 inches long is made over the temporal artery.
- Two clamps are placed on the artery about 2 inches apart.
- A small section of the artery between the clamps is cut and taken out.
- The tissue under the skin will be closed with dissolvable stitches, and the skin will be closed with small stitches that must be removed later.
- The biopsy site may be dressed with medicine and a small bandage.
- The removed piece of artery will be examined under a microscope, which will reveal if temporal arteritis is present.
What to Expect After a Temporal Artery Biopsy
If given a sedative before the procedure, the patient will wait in a recovery room until it wears off. After blood pressure and pulse are checked, and if everything is normal, the patient can be taken home.
The patient can eat and drink normally.
A small amount of non-severe pain is normal as the pain medication wears off. A healthcare provider may prescribe pain medication, but the patient should make sure to ask before taking any over-the counter painkillers.
A small bandage will cover the temple, and the patient should ask about incision care, if he or she should keep from getting the incision wet, and when the bandage can be removed.
The temporal artery needs several days to heal, so the patient should undergo no strenuous activity for this time period.
The patient will need to make an appointment to return to have the stitches removed after the time period recommended by the health care provider.
The patient should not drive for 24 hours after the procedure to ensure the sedative is completely worn off.
Risks and Complications of a Temporal Artery Biopsy
- Temporal artery biopsy is considered a very safe procedure. Even though complications are rare, a small amount of risks exist including:
- Uncontrollable bleeding.
- Hematoma (lump caused by bleeding under the skin).
- Pain that persists after taking pain medication.
- Temporal nerve damage. Facial muscles can become weak or a patient may feel numbness in the face.
- Scarring: If a scar occurs on the scalp, hair may not grow around the scar.
Prognosis after of a Temporal Artery Biopsy
A temporal artery biopsy is not a cure or treatment for temporal arteritis. The procedure helps with the diagnosis of temporal arteritis. If the biopsy indicates a positive diagnosis, treatment for temporal arterits can start. Treatment is usually highly successful.
If you would like to schedule an appointment with one of our physicians at the Texas Center for Obesity Surgery in Plano, please complete an online appointment request or call our office at 214-501-1333.