Temporal Artery Ligation

Q: Dr. Eppley, I has a temporal artery ligation procedure done by a doctor in Beverly Hills who performed 2 point ligations on each side and double tied) a little over 6 weeks ago.  The left side did not work – the pulsation is still there – and the doctor is going to go back in a few months to retreat it.  On the right side, the pulsation is gone, however, I worked out very hard today, and the artery swelled up and the zig zag that was previously there (and previously had the pulsation) is back – but this time with NO pulsation. Has this happened to any of your patients (where the pulsation went away but the outline of the artery is still there)?  My doctor here has not seen this before.  And if so, what can be done to further correct it? 

A: In temporal artery ligation If you don’t strip the artery of blood before you tie off the ends, blood will stagnate in the vessel and its appearance may remain… albeit with no pulsation. But the most likely reason is that not all contributing feeders have been ligated. I have found that rarely does just two point ligation work well. Without knowing what the specific ligations locations are or what your arterial pattern was before surgery, I can not provide any further meaningful insight.

Dr. Barry Eppley

Indianapolis, Indiana