How soon after starting treatment for Takayasu arteritis do you decide on the need for any vascular interventions to manage chronic damage?

To answer this question, several elements need to be considered. As a rule of thumb, in TAK and large vessel vasculitis in general, it is recommended to perform vascular surgery at the time of disease remission to prevent complications during the surgical procedure and in the immediate postoperative period. In case of active disease, it is recommended to start immunosuppressive treatment (usually with glucocorticoids) and proceed with surgery weeks to months down the road to ensure that arterial...

I completely agree with the statements by Dr. @Dr. First Last above. The timing (and indications for) vascular intervention in patients with Takayasu arteritis should be individualized. Unless the intervention is emergent, vascular inflammation should be treated medically, and then the patient can be reassessed after 3-6 months with comprehensive imaging studies (such as PET imaging) to ensure (as best we can) that the vasculitis is in remission before intervention.