Biopsy of the Temporal Artery

Abstract

The editorial entitled “Is Temporal Artery Biopsy Prudent?” by Hall and Hunder in the November 1984 issue of the Proceedings (pages 793 through 796) was informative and clinically useful. In the discussion of the risks associated with temporal artery biopsy, however, one possible situation was not mentioned. My colleagues and I have occasionally encountered patients with an occluded internal carotid artery in whom the blood supply to the ipsilateral hemisphere was conveyed through the superficial temporal artery, superior orbital artery, and ophthalmic artery. In this circumstance, sacrifice of the superficial temporal artery could deprive the ipsilateral hemisphere of this important collateral blood supply. Although I have never seen a report of stroke complicating temporal artery biopsy, it would seem to be a possibility. I would be interested in knowing whether the authors are aware of such a complication. Perhaps when a patient has a carotid bruit or ancillary evidence of cerebrovascular disease, it might be prudent to obtain ocular plethysmographic or other noninvasive ultrasound data to assess the possibility of a naturally occurring superficial temporal artery-carotid artery bypass, before temporal artery biopsy is done. Biopsy of the Temporal Artery: The authors replyMayo Clinic ProceedingsVol. 60Issue 3PreviewWe thank Dr. Adornato for his letter about our editorial on temporal artery biopsy. We agree that a temporal artery biopsy in the setting described by him could deprive the ipsilateral cerebral hemisphere of an important collateral blood supply. In such cases, a biopsy of the opposite temporal artery could be done, if it is indicated. We have not seen a case, nor are we aware of a published report, of a stroke complicating temporal artery biopsy. Thus, fortunately, his question seems to be more theoretical than real. Full-Text PDF