Parreau Simon, Liozon Eric, Chen John J, Curumthaullee Muhammad F, Fauchais Anne-Laure, Warrington Kenneth J, Ly Kim-Heang, Weyand Cornelia M
Department of Internal Medicine, Dupuytren Hospital, Limoges, France; Department of Rheumatology, Mayo Clinic, Rochester, MN, USA.
Department of Internal Medicine, Dupuytren Hospital, Limoges, France.
Surv Ophthalmol. 2023 Jan-Feb;68(1):104-112. doi: 10.1016/j.survophthal.2022.08.008. Epub 2022 Aug 20.
Temporal artery biopsy (TAB) is a surgical procedure that enables the histological diagnosis of giant cell arteritis (GCA). Performing a TAB requires expertise and a precise approach. Nevertheless, available data supports the value of tissue diagnosis in managing GCA. The current therapeutic recommendation for GCA is long-term glucocorticoid therapy, with an increasing emphasis on the addition of immunosuppressants/biotherapies. Though effective, immunosuppressants and other such biotherapies may put the patient at more risk. Optimizing the diagnosis through tissue evaluation is therefore important in weighing the risks and benefits of initiating therapeutic intervention. We evaluate the evidence supporting the importance of TAB and its indications. We also describe what technical approaches should be used to maximize sensitivity and to avoid possible complications during the procedure.
颞动脉活检(TAB)是一种能够对巨细胞动脉炎(GCA)进行组织学诊断的外科手术。进行TAB需要专业知识和精确的操作方法。然而,现有数据支持组织诊断在GCA管理中的价值。目前GCA的治疗推荐是长期糖皮质激素治疗,并且越来越强调加用免疫抑制剂/生物疗法。尽管有效,但免疫抑制剂和其他此类生物疗法可能会使患者面临更多风险。因此,通过组织评估优化诊断对于权衡启动治疗干预的风险和益处很重要。我们评估了支持TAB重要性及其适应证的证据。我们还描述了应采用哪些技术方法来最大限度地提高敏感性并避免手术过程中可能出现的并发症。