TABLE 1. Clinical Scenarios in Which Treatment of Significant RAS^α May be Considered.

A summary table from a consensus statement issued by the Society for Cardiovascular Angiography and Interventions (SCAI) identifies the reasonably appropriate indications for renal artery stenting. The document attempts to synthesize both levels of evidence and experience into an overall scheme for which renal revascularization offers true clinical benefits. (reproduced from Reference 6, with permission)

Appropriate Care	Cardiac Disturbance Syndromes (Flash Pulmonary Edema or acute coronary syndrome (ACS)) with severe hypertension Resistant HTN (Uncontrolled hypertension with failure of maximally tolerated doses of at least three antihypertensive agents, one of which is a diuretic, or intolerance to medications Ischemic nephropathy with chronic kidney disease (CKD) with eGFR < 45 cc/min and global renal ischemia (unilateral significant RAS with a solitary kidney or bilateral significant RAS) without other explanation
May Be Appropriate Care	Unilateral RAS with CKD (eGFR < 45 cc/min) Unilateral RAS with prior episodes of congestive heart failure (Stage C) Anatomically challenging or high risk lesion (early bifurcation, small vessel, severe concentric calcification, and severe aortic atheroma or mural thrombus)
Rarely Appropriate Care	Unilateral, Solitary, or Bilateral RAS with controlled BP and normal renal function Unilateral, Solitary, or Bilateral RAS with kidney size <7 cm in pole-to-pole length Unilateral, Solitary, or Bilateral RAS with chronic end stage renal disease on hemodialysis > 3 months Unilateral, Solitary, or Bilateral renal artery chronic total occlusion

^αSignificant RAS is an angiographically moderate lesion (50–70%) with physiologic confirmation of severity or a > 70% stenosis