How is a temporal artery biopsy performed?

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

Answer

Make the incision with a No. 15 blade scalpel directly over the artery, penetrating only skin and subcutaneous tissue to avoid injuring the underlying vessel. The blade should be beveled in the plane of the temporal hair shafts to avoid transecting the bulbs, which results in incisional alopecia. Also, avoid cautery of bleeding skin vessels if possible. See video below.

Incision.

Bluntly dissect through the subcutaneous fat and into the temporoparietal fascia. The vessel is found within the temporoparietal fascia. See video below.

Superficial dissection.

See the list below:

  • Carry out blunt dissection with a hemostat, spreading parallel to the vessel to avoid tearing it during exposure. See video below.

    Dissection of superficial temporal artery.
  • Maintain hemostasis with electrocautery throughout the dissection to minimize the chance of hematoma formation.

  • Once identified, carefully dissect the surrounding connective tissue to expose 3-5 cm of the vessel. Clamp the vessel with hemostats proximally and distally and use 3-0 silk ties to ligate the vessel. See video below.

    Harvest of the superficial temporal artery.

Cut the intervening segment of artery using the No. 15 blade scalpel and send it to pathology in formalin.


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