Temporal Artery Ligation
Q: Dr. Eppley, . I have seen you have had experience with temporal artery ligation and success dealing with this procedure in the past which is why I am contacting you. Attached is a picture of my problem. The artery gets larger if my heart rate is up or its hot outside. I have another one that is not as bad on my left side as well that I would like to deal with at some point if the initial procedure works. Is the success rate of this procedure pretty high, in terms of greatly minimizing the size of the entire artery? I am very interested in having this procedure done.
A: The success rate of temporal artery ligation in my experience is always 100% or very close. That would be expected when you shut down both ends of the pipe so to speak. That is actually not the question that is the most relevant. The more relevant question is…does collateralization or shunting of flow occur? This means if you shut down one section of the pipe way will other previously invisible sections of the pipeline appear later. It is important to remember that all the arteries in the scalp and forehead are very extensive and interconnected. So in theory the blood flow that went to the vessel that was shut down could be shunted and cause vessel dilation elsewhere. I only mention this point in cases of men that shave their head where the entire scalp can be seen. I have had a few patients contact me over the years who had their temporal arteries ligated elsewhere and they developed visible dilated vessels elsewhere in the scalp weeks to months later which they felt was a worse aesthetic problem than the one they had treated. This shunting is not a problem that I have seen with temporal arerty ligation but it is one of which to be aware and a potential risk of the surgery.
Dr. Barry Eppley