Temporal Artery Biopsy

Temporal Artery Biopsy

Anesthesia type	MAC
Airway	Nasal Canual
Lines and access	PIV
Monitors	Standard
Primary anesthetic considerations
Preoperative	Shared workspace – the surgeon will be prepped and draped at roughly the ear
Intraoperative	Be careful not to break sterile field when giving jaw thrust. Both arms likely tucked
Postoperative
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Temporal artery biopsy is the primary modality to diagnose giant cell arteritis / temporal arteritis.

Giant cell arteritis is a chronic vasculitis affecting medium and large diameter arteries. It predominantly affects older individuals and will affect: aortic arch vessels and branches, and external carotid artery. The clinical manifestations result from inflammation of the affected arteries or from their gradual occlusion leading to signs of arterial ischemia.

Overview

Indications

Giant cell arteritis conformation

Surgical procedure

Incision is generally made overlying the superficial temporal artery at the previously chosen side and site (which can be found via doppler)

Preoperative management

Patient evaluation

System	Considerations
Airway	Shared workspace with surgeon. Caution when giving jaw thrust
Neurologic
Cardiovascular
Pulmonary
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Operating room setup

Can be done under local only.

MAC with Propofol

Intraoperative management

Monitoring and access

Standard montioring

Positioning

Supine

Arms tucked

Maintenance and surgical considerations

Caution when giving jaw thrust given close proximity to surgery.

Postoperative management

Disposition

Home (same day procedure)

Pain management

Fentanyl + local give by surgeon

Potential complications

Facial nerve injury

Procedure variants

	Variant 1	Variant 2
Unique considerations
Indications	Giant Cell Arteritis
Position	Supine
Surgical time	30-60 minutes
EBL	Minimal
Postoperative disposition
Pain management	Minimal
Potential complications	Facial nerve injury