What is temporal artery biopsy and how is it used?

Updated: Sep 04, 2018
  • Author: Andrew A Winkler, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Temporal arteritis, also known as giant cell arteritis, is an inflammatory vasculopathy affecting medium- and large-sized arteries. While the superficial temporal branch of the carotid artery is particularly susceptible, arteries at any site can be affected. Temporal arteritis is defined by a granulomatous panarteritis with mononuclear cell infiltrates and giant cell formation within the vessel wall. [1] This unique histologic characteristic confirms the diagnosis of temporal arteritis in biopsy specimens of the temporal artery (TA).

Although temporal artery biopsy has long been considered the gold standard for diagnosis of temporal arteritis, due to its 100% specificity, noninvasive diagnosis using imaging studies is gaining favor. [2]   For example, 2018 European guidelines recommend that the diagnosis of giant cell arteritis can be made without biopsy in cases where there is a high clinical suspicion and a positive imaging test. [3]

This article provides a method for consistent, safe, and cosmetically sensitive biopsy of the superficial temporal artery (Current Procedure Terminology [CPT] code 37609). The relevant anatomy, indications, and contraindications for this procedure are also reviewed. The video below includes an introduction to the procedure.

Introduction by Dr. Andrew Winkler.

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