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Temporal Artery Biopsies: Understanding the Low Positivity Rate
Stella-Marie Girard1, Caroline François2,1,3
1Plastic and Reconstructive Surgery, Christian Cabrol Hospital, Reims, FRA.
Cureus
|May 5, 2025
Summary
Temporal artery biopsies show a low positivity rate for giant cell arteritis. Clinical diagnosis often differs, highlighting the need for refined indications and techniques for this suspected Horton
Area of Science:
- Vascular Surgery
- Rheumatology
- Pathology
Background:
- Giant cell arteritis (GCA) diagnosis relies on clinical suspicion and temporal artery biopsy (TAB).
- Discordance between clinical diagnosis and biopsy results is a known challenge in GCA management.
Purpose of the Study:
- To compare TAB yield with referring physicians' clinical diagnoses in suspected GCA.
- To identify factors associated with a positive TAB result.
Main Methods:
- Retrospective analytical study of 72 patients undergoing TAB for suspected GCA (January 2021 - December 2024).
- Analysis of patient factors, symptoms, and surgical/pathological variables.
- Comparison of biopsy positivity rate with final clinical diagnoses.
Main Results:
- TAB positivity rate was 16.6% (12/72).
- General health deterioration was significantly associated with a positive biopsy (OR = 3.71, p = 0.05).
- Physicians diagnosed Horton's disease in 55.5% of cases, often discordant with biopsy findings.
Conclusions:
- Significant anatomic-clinical discordance exists in suspected GCA, influenced by pathology and diagnostic/surgical variability.
- Refined indications and improved surgical techniques are needed for TAB.
- TAB should be reserved for strongly suspected cases of Horton's disease, with sampling upstream from the superficial temporal artery bifurcation recommended.
Keywords:
general plastic surgerygood clinical practiceslarge-vessel vasculitis and gcatemporal arteritistemporal artery biopsyMore Related Videos
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