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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| Editor rating | |
| User likes | 0 |
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 |
Labs and studies
Operating room setup
Can be done under local only.
MAC with Propofol
Patient preparation and premedication
Regional and neuraxial techniques
Intraoperative management
Monitoring and access
Standard montioring
Induction and airway management
Positioning
Supine
Arms tucked
Maintenance and surgical considerations
Caution when giving jaw thrust given close proximity to surgery.
Emergence
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 |