Parietal branch of the superficial temporal artery: An underutilized biopsy site

Abstract

Purpose: Giant cell arteritis (GCA) is an immune-mediated vasculitis that can lead to significant symptoms and disease sequelae such as headaches, fevers, weight loss, jaw pain, optic neuropathy with permanent vision loss, and stroke. The gold standard for diagnosis of GCA is a temporal artery biopsy (TAB) as it has a high specificity and sensitivity. The TAB is commonly harvested from the frontal branch of the superficial temporal artery, however given its location, there are potentially significant consequences including facial nerve injury and poor cosmetic outcomes. An alternative to this method is biopsy of the parietal branch, as it reduces the risk of facial nerve injury and comfortably hides the scar line within the hair of most patients. Results: We describe in detail our department's TAB technique and experience from pre-procedure preparation to post-procedure care. Conclusion: The parietal branch TAB is a typically underutilised, well tolerated and viable alternative to the frontal branch TAB and it may be considered in the first instance to reduce the risk of complications.