I have gone through case history.I can understand your concern.you have 90% stenosis of Right Renal artery and proximal SMA.Scientifically whenever any artery is blocked more than70% it should be tackled either by plasty with stent or graft.your uncontrolled blood pressure also points that you need to dilate Rt.renal artery followed by stenting ,As far as SMA block is concerned one needs to look at angiogram for extent and type of block to decide what can be offered to this block.One thing is certain you will need intervention.My best wishes.