Can Perioperative Use of Anticoagulants or Platelet Antiaggregants be Continued for Temporal Artery Biopsy?

Abstract

G iant cell arteritis (GCA) or temporal arteritis (TA) is a chronic systemic inflammatory vasculitis affecting the large and medium vessels in people aged over 50 years with a peak incidence over the age of 70. Giant cell arteritis patients present with higher rates of selected comorbidities, such as venous thromboembolic diseases and cerebral vascular accidents. Over 1% of GCA patients develop visual complication after the disease onset, of whom 21% develop unilateral or bilateral complete visual loss. The visual change results from an occlusion of the posterior ciliary arteries or central retinal artery. Early diagnosis of GCA is of paramount importance for effective treatment, and temporal artery biopsy (TAB) is considered as the criterion standard diagnostically. The TAB is a common procedure, and its associated complications include ecchymosis, hematoma, infection, scarring, and wound dehiscence. Brow ptosis can result from a surgical damage of the facial nerve. To date, very few studies of the potential TAB-associated complications have been available.Moreover, there are no guidelines on perioperative anticoagulation (AC) and antiplatelet (AP) usage for the TAB. As a result, there is inconsistent practice in this regard. Herein, our study aimed to analyze the TAB-associated complications and to provide meaningful guidance on AC and AP use before the TBA procedure in conjunction with the literature.