11
(cont'd) (cont'd)
Table 5. Recommendations/Statements for Medical and
Surgical Management in TAK
B. Surgical Management (cont'd) Level of Evidence
In patients with TAK and stenosis of a cranial/cervical vessel
without clinical symptoms, we conditionally recommend medical
management over surgical intervention.
Very low / Low
In patients with TAK with worsening signs of limb/organ ischemia,
we conditionally recommend delaying surgical intervention until
the disease is quiescent over performing surgical intervention while
the patient has active disease.
Very low / Low
In patients with TAK undergoing surgical intervention, we
conditionally recommend using high dose glucocorticoids in the
peri-procedure period if the patient has active disease.
Very low / Low
Table 6. Recommendations for Clinical/Laboratory
Monitoring and Vascular Imaging in TAK
A. Clinical/Laboratory Monitoring Level of Evidence
In patients with TAK, we conditionally recommend adding
inflammatory markers to clinical monitoring as a disease activity
assessment tool.
Very low / Low
In patients with TAK in apparent remission, we strongly recommend
long-term clinical monitoring over no clinical monitoring.
Very low
In patients with TAK in apparent clinical remission but with
rising inflammatory markers, we conditionally recommend
clinical observation without escalation of immunosuppression.
Very low
B. Vascular Imaging Level of Evidence
In patients with TAK, we conditionally recommend using non-
invasive imaging over catheter-based dye angiography as a disease
activity assessment tool.
Low
In patients with known TAK, we conditionally recommend
regularly scheduled non-invasive imaging in addition to routine
clinical assessment.
Very low / Low
In patients with TAK in apparent clinical remission but with signs
of inflammation in new vascular territories (e.g., new stenosis or
vessel wall thickening ) on vascular imaging, we conditionally
recommend treatment with immunosuppressive therapy.
Very low / Low
(cont'd)
