Temporal Artery Biopsy

Temporal artery biopsy is a minor surgical procedure to obtain a sample of the temporal artery for microscopic examination. It's the gold standard for diagnosing giant cell arteritis (GCA).

Why It's Done

• Confirm suspected GCA
• Guide long-term treatment decisions
• Provide definitive diagnosis for records
• Important because GCA treatment is lengthy

What to Expect

Before the Procedure

• Blood thinners may be held (discuss with doctor)
• Local anesthesia used
• Usually done in office or minor procedure room

During the Procedure

• Area above ear (temple) cleaned and numbed
• Small incision made
• 2-3 cm segment of artery removed
• Artery tied off (plenty of other blood supply)
• Incision closed with sutures
• Takes about 30 minutes

After the Procedure

• Mild discomfort, bruising expected
• Keep wound clean and dry
• Sutures removed in 7-10 days
• Numbness near incision temporary
• Resume normal activities in 1-2 days

Timing of Biopsy

Important Points

• Start steroids immediately if GCA suspected
• Don't wait for biopsy to treat
• Biopsy can be positive for 2-4 weeks after starting steroids
• Should be done within 2 weeks of starting treatment

Results

Positive Biopsy

• Shows characteristic inflammation
• Giant cells, vessel wall inflammation
• Confirms diagnosis

Negative Biopsy

• Doesn't completely rule out GCA
• "Skip lesions"—inflammation may be patchy
• Clinical judgment still important
• Second biopsy sometimes considered

Risks

• Bleeding, bruising
• Infection (rare)
• Temporary numbness near incision
• Scarring (usually hidden in hairline)
• Very safe procedure overall