Page 9 - Carotid and peripheral vascular interventions textbook
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                   Table 10-3. ACC/AHA/SCAI/SIR/SVM 2018 Appropriate Use Criteria (AUC) for Treatment of ARAS-.
                   (Modif ed from Bailey SR, Beckman JA, Dao TD, et al. ACC/AHA/SCAI/SIR/SVM 2018 Appropriate
                   use criteria for peripheral artery intervention: A report of the American College of Cardiology Appropriate Use
                   Criteria Task Force, American Heart Association, Society for Cardiovascular Angiography and Interventions.
                   J Am Coll Cardiol. 2019;73:214-237, with permission from Elsevier).

                    Indications                               AUC Score

                                                                               Renal Stent Placement
                                                              Continue or Intensify  (Primary Stenting) –
                                                              Medical Therapy  Atherosclerotic Lesions

                    Hemodynamically Significant RAS (With a Severe [70-99%] RAS or 50-69% RAS with hemodynamic Significance)
                    Chronic Kidney Disease*
                    1.  • Bilateral RAS or a solitary viable† kidney with RAS           Appropriate
                        • Accelerating decline in renal function                      (Class IIa, LOE B)
                    2   • Unilateral RAS                                             May Be Appropriate
                        • Accelerating decline in renal function  Appropriate         (Class IIb, LOE C)
                                                                (Class I, LOE A)
                    3   • Unilateral smaller kidney (<7cm pole to pole)               Rarely Appropriate

                    4   • Failure to control BP on 3 maximally tolerated              May Be Appropriate
                         medications, 1 of which is a diuretic                        (Class IIa, LOE B)

                    5   • Uncontrolled on <3 antihypertensive medications
                                                                (Class I, LOE A)      Rarely Appropriate
                    6   • Well-controlled BP on ≥2 antihypertensive medications
                    7   • New onset
                        • No medical management
                    Cardiac Destabilization
                    8   • Sudden-onset f ash pulmonary edema                            Appropriate
                                                                                       (Class I, LOE B)
                    9   • Recurrent ADHF requiring hospitalization                   May Be Appropriate
                        • Uncontrolled on maximal medical therapy                      (Class I, LOE B)
                    10  • Uncontrolled unstable angina despite maximal medical        May Be Appropriate
                         therapy                                                      (Class IIa, LOE B)

                    Incidentally Discovered RAS
                    11  • Bilateral RAS or a solitary viable† kidney with RAS  Appropriate
                                                                (Class I, LOE A)      Rarely Appropriate
                    12  • Unilateral RAS

                    Borderline (50-69 %) RAS Without Hemodynamic Confirmation of Severity
                    13  • Unilateral RAS, bilateral RAS, or a solitary viable†   Appropriate
                         kidney with RAS                        (Class I, LOE A)      Rarely Appropriate

                   *Chronic kidney disease was def ned as a decrease in estimated GFR rate <60mL/min/1.73 m  or serum creatinine >1.5mg/dl that persisted
                   for at least 3 months.
                   †Viable is pole to pole kidney length ≥7cm.
                   ADHF, acute decompensated heart failure; BP, blood pressure; RAS, renal artery stenosis
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