Temporal Artery Biopsy: A 10-Year Multi-centre Review of Current Practice

Area of Science:

• Rheumatology
• Vascular Surgery
• Histopathology

Background:

• Giant cell arteritis (GCA) diagnosis often relies on temporal artery biopsies (TAB).
• The clinical utility of TAB in managing GCA requires further investigation.

Purpose of the Study:

• To assess the clinical utility of TAB in diagnosing GCA.
• To evaluate the impact of TAB on subsequent GCA medical management.

Main Methods:

• A 10-year retrospective analysis of 216 patients who underwent TAB.
• Data collected included patient risk factors, pre-operative steroid use, biopsy specimen length, and histopathology findings.

Main Results:

• 80.6% of patients started steroids before TAB.
• Only 18.5% of TABs were histopathologically positive.
• 37.3% of patients with negative TABs completed steroid therapy; 14.9% underwent TAB despite pre-documented plans to continue steroids regardless of results.

Conclusions:

• TAB has limited utility in guiding GCA medical management.
• A significant number of patients continue steroid therapy irrespective of biopsy results.
• Improved clinical probability scores are needed to guide steroid cessation.