Cantini F, Niccoli L, Storri L Are polymyalgia rheumatica and giant cell arteritis the same disease?. Semin Arthritis Rheum.. 2004; 33:(5)294-301

Chu R, Foster C, Ali M Optimal length and usefulness of temporal artery biopsies in the diagnosis of giant cell arteritis: a 10-year retrospective review of medical records. Lancet Rheumatology.. 2020; 2:(12)E774-E778

Cummings GG, Fraser K, Tarlier DS. Implementing advanced nurse practitioner roles in acute care: an evaluation of organizational change. J Nurs Adm.. 2003; 33:(3)139-145

Dasgupta B Concise guidance: diagnosis and management of giant cell arteritis. Clin Med (Lond).. 2010; 10:(4)381-6

Dasgupta B, Borg FA, Hassan N BSR and BHPR guidelines for the management of giant cell arteritis. Rheumatology (Oxford).. 2010; 49:(8)1594-1597

Polymyalgia rheumatica and giant cell arteritis. In: Dasgupta B, Dejaco C (eds). Oxford: Oxford Rheumatology Library/Oxford University Press;

Dejaco C, Duftner C, Buttgereit F, Matteson EL, Dasgupta B. The spectrum of giant cell arteritis and polymyalgia rheumatica: revisiting the concept of the disease. Rheumatology (Oxford).. 2017; 56:(4)506-515

There's a S.M.A.R.T. way to write management's goals and objectives. 1981. (accessed 21 April 2021)

González-Gay MA, García-Porrúa C. Epidemiology of the vasculitides. Rheum Dis Clin North Am.. 2001; 27:(4)729-749

González-Gay MA, Vazquez-Rodriguez TR, Lopez-Diaz MJ Epidemiology of giant cell arteritis and polymyalgia rheumatica. Arthritis Rheum.. 2009; 61:(10)1454-1461

Hellmich B, Agueda A, Monti S 2018 update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis.. 2020; 79:(1)19-30

Mackie SL, Dejaco C, Appenzeller S British Society for Rheumatology guideline on diagnosis and treatment of giant cell arteritis. Rheumatology (Oxford).. 2020; 59:(3)e1-e23

Mackie SL, Brouwer E. What can negative temporal artery biopsies tell us?. Rheumatology (Oxford).. 2020; 59:(5)925-927

Mollan SP, Sharrack N, Burdon MA, Denniston AK. Aspirin as adjunctive treatment for giant cell arteritis. Cochrane Database Syst Rev.. 2014; 8

Mollan SP, Paemeleire K, Versijpt J, Luqmani R, Sinclair AJ. European Headache Federation recommendations for neurologists managing giant cell arteritis. J Headache Pain.. 2020; 21:(1)

National Institute for Clinical Excellence. Giant cell arteritis. Clinical knowledge summary. 2020. (accessed 21 April 2021)

National Institute for Clinical Excellence. Tocilizumab for treating giant cell arteritis. Technology appraisal guidance: TA518. 2018. (accessed 21 April 2021)

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Polymyalgia rheumatica and giant cell arteritis. 2016. (accessed 21 April 2021)

National Organisation of Rare Diseases. Giant cell arteritis. 2019. (accessed 21 April 2021)

Neville L, Swift J. Measuring the impact of the advanced practitioner role: a practical approach. J Nurs Manag.. 2012; 20:(3)382-9

The role of the advanced nurse practitioner. Blog. 2019. (accessed 21 April 2021)

Enduring ambiguity: the ANP role. 2020. (accessed 21 April 2021)

Poller DN, van Wyk Q, Jeffrey MJ. The importance of skip lesions in temporal arteritis. J Clin Pathol.. 2000; 53:(2)137-9

Royal College of Nursing. Royal College of Nursing standards for advanced level nursing practice. 2018. (accessed 21 April 2021)

Rubenstein E, Maldini C, Gonzalez-Chiappe S, Chevret S, Mahr A. Sensitivity of temporal artery biopsy in the diagnosis of giant cell arteritis: a systematic literature review and meta-analysis. Rheumatology (Oxford).. 2020; 59:(5)1011-1020

Sait M, Lepore M, Kwasnicki R The 2016 revised ACR criteria for diagnosis of giant cell arteritis—our case series: can this avoid unnecessary temporal artery biopsies?. International Journal of Surgery Open.. 2017; 17:19-23

Salvarani C, Cantini F, Hunder GG. Polymyalgia rheumatica and giant-cell arteritis. Lancet.. 20081; 372:(9634)234-45

Giant cell arteritis (temporal arteritis) workup. 2020.

Sharma A, Mohammad AJ, Turesson C. Incidence and prevalence of giant cell arteritis and polymyalgia rheumatica: a systematic literature review. Semin Arthritis Rheum.. 2020; 50:(5)1040-1048

Smeeth L, Cook C, Hall AJ. Incidence of diagnosed polymyalgia rheumatica and temporal arteritis in the United Kingdom, 1990-2001. Ann Rheum Dis.. 2006; 65:(8)1093-1098

Tuckwell K, Collinson N, Dimonaco S Newly diagnosed vs. relapsing giant cell arteritis: Baseline data from the GiACTA trial. Semin Arthritis Rheum.. 2017; 46:(5)657-664

Vasculitis UK. What is giant cell arteritis/temporal arteritis?. 2019. (accessed 21 April 2021)

BMJ best practice. Giant cell arteritis. 2020. (accessed 21 April 2021)

Weyand CM, Liao YJ, Goronzy JJ. The immunopathology of giant cell arteritis: diagnostic and therapeutic implications. J Neuroophthalmol.. 2012; 32:(3)259-65

Wong CA, Cummings GG, Ducharme L. The relationship between nursing leadership and patient outcomes: a systematic review update. J Nurs Manag.. 2013; 21:(5)709-724

Yates M, Graham K, Watts RA, MacGregor AJ. The prevalence of giant cell arteritis and polymyalgia rheumatica in a UK primary care population. BMC Musculoskelet Disord.. 2016; 17

Introducing an ANP-led temporal artery biopsy service for patients with suspected giant cell arteritis

13 May 2021
Volume 30 · Issue 9


Giant cell arteritis (GCA) is an uncommon autoimmune inflammatory vasculopathy that can lead to the destruction and occlusion of various arteries that consequently can cause serious complications such as stroke or sight loss. It is seen as a medical emergency. The most commonly affected vessel in GCA is the temporal artery in the side of the head, hence the condition is sometimes also referred to as ‘temporal arteritis’. This article discusses the introduction of an advanced nurse practitioner-led temporal artery biopsy service.

This article provides a summary of the symptoms, diagnosis, treatment and management of giant cell arteritis (GCA) in order to provide context for a review of the introduction of an advanced nurse practitioner (ANP)-led temporal artery biopsy service (TAB).

According to the National Institute for Health and Care Excellence (NICE) (2020), GCA is defined as an autoimmune chronic vasculitis which is associated with inflammation within the muscular walls of the arteries. The condition is sometimes also referred to as ‘temporal arteritis’ due to the temporal artery in the side of the head often being affected (Vasculitis UK, 2019) (Figure 1).

Figure 1. A lateral view of the blood supply of the head and neck, showing the position of the temporal artery

The cause of GCA is unknown, although genetic and environmental factors have been linked to a predisposition to the disease (Genetic and Rare Diseases Information Center (GARD), 2017). GCA is predominately associated with affecting the medium to large arteries in the head, especially extracranial branches of the carotid artery and the ophthalmic artery (NICE, 2020). Other arteries elsewhere in the body can also be involved, including, for example, the aorta, but this is uncommon within those diagnosed with GCA (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2016).

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