Temporal Artery Biopsy
This is Richard Allen at the University of Iowa. This video demonstrates a temporal artery biopsy.
The artery has been palpated and marked with a marking pen. A bit of hair has been shaved.
The area is then infiltrated with lidocaine with epinephrine around the area. Care is taken not to inject directed into the artery.
A 15 blade is then used to make an incision through the skin to expose the underlying subcutaneous fat. Hemostasis is attained with bipolar cautery.
A cotton tip applicator is then used to bluntly dissect through the subcutaneous fat to the superficial temporalis fascia where the artery resides.
The artery is identified. Additional dissection can be performed with Westcott scissors.
A 4-0 silk suture is then used to ligate the artery both distally and proximally.
Care is taken not to puncture the artery. Some surgeons prefer to place the suture backwards or dissect under the artery.
The artery is then excised with Wescott scissors taking care not to cut across the artery.
Sometimes there will be branches of the artery that were not identified. These should be cauterized if bleeding occurs as is done here.
Dissection is continued to excise the artery.
Ideally two to three centimeters of artery is excised.
Additional cautery is used as needed.
The incision is then closed with deep interrupted 5-0 vicryl sutures. Approximately 3-5 sutures are placed.
The skin is then closed with your suture of choice, in this case a running 5-0 fast absorbing suture is used.
Antibiotic ointment is placed at the conclusion of the case and a pressure dressing is placed for 24 to 48 hours.