P.045 Biopsies of the transverse carpal ligament and tenosynovium for tissue confirmation of transthyretin amyloidosis

Background: Transthyretin Amyloidosis (ATTR) is a common cause of both cardiomyopathy and carpal tunnel syndrome, with many patients needing release (CTR). Although tafamidis now an approved treatment ATTR cardiomyopathy, insurers in most provinces require biopsy confirmation amyloidosis. Endomyocardial often the chosen approach due to optimal sensitivity, albeit risk serious adverse events such as stroke, cardiac tamponade, arrhythmias. CTR may present ideal opportunity for obtaining amyloidosis confirmation. Methods: undergoing had their transverse ligament (TCL) and/or flexor tenosynovium assess sensitivity sites Results: Twelve consecutively underwent biopsies during CTR, 4 (33%) having bilateral biopsy. Among 16 TCL 14 biopsies, 100% demonstrated amyloid deposition. Another patient isolated without also There were no events, 1/13 (8%) wound dehiscence requiring repeat suturing. Conclusions: Biopsy safe, cost-effective, sensitive, represent alternative endomyocardial tissue approval. eligible benefit from early neurology assessment.