Temporal artery biopsy #2
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This is Richard Allen at the University of Iowa. This is an additional video demonstrating a temporal artery biopsy. The artery has been palpated and a marking pen has marked the area. The area has been anesthetized and a 15 blade is used to make an incision through the skin. The incision is then continued through the subcutaneous fat. Cotton tip applicators can then be used to bluntly dissect the subcutaneous fat from the underlying superficial temporalis fascia. The artery resides in the superficial temporalis fascia. The artery is demonstrated. Hemostasis is obtained with bipolar cautery. Again, the artery is demonstrated. Westcott scissors can then be used to dissect out the artery. Care should be taken to not cut into the artery and also to identify any branches of the artery. 4-0 Silk suture is used to place a ligature on each end of the artery. During dissection, a branch of the artery was identified and a ligature is placed around it. Wescott scissors are then used to excise the artery. The scissors should be placed right up against the Silk suture to obtain as long of a piece of the artery as possible. Again, care should be taken to not cut into the artery. The artery is removed and sent to the pathologist for evaluation. Hemostasis is obtained with the bipolar cautery. The incision is then closed with deep interrupted 5-0 Vicryl sutures placed in a buried fashion. The skin is closed with a running superficial 5-0 fast absorbing suture. A pressure patch will be placed which can be removed after 24 hours. The patient will then use antibiotic ointment 3 times per day and the patient will return in 1-2 weeks for reevaluation.
