Abdominal Vasculature

Source: Khosa F, Krinsky G, Macari M, Yucel EK, Berland LL. Managing incidental findings on abdominal and pelvic CT and MRI, Part 2: white paper of the ACR Incidental Findings Committee II on vascular findings. J Am Coll Radiol. 2013;10(10):789-794. doi:10.1016/j.jacr.2013.05.021

AAA

Arterial Abnormalities

Penetrating Aortic Ulcer	Asymptomatic: annual follow-up Symptomatic: “more frequent”
Iliac Artery Aneurysm	<3.0 cm: no follow-up 3.0-3.5 cm: 6 month follow up >3.5 cm: “expeditious follow-up”
Splenic Artery Aneurysm	<2 cm: annual follow-up* >2cm: surgical referral
Renal Artery Aneurysm	<1.5 cm: 1-2 year follow up >1.5 cm: surgical referral
Pancreaticoduodenal Aneurysm	All should have surgical referral
Other Aneurysms	In general, if >2 cm surgical referral
Visceral dissection	Asymptomatic: follow-up imaging

*Consider risk factors for rupture: rapidly increasing size, occurrence in women of childbearing years, cirrhosis, symptomatic.

Society for Vascular Surgery guidelines. Source: Chaer RA, Abularrage CJ, Coleman DM, et al. The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms. J Vasc Surg. 2020;72(1S):3S-39S. doi:10.1016/j.jvs.2020.01.039

Venous Abnormalities

May Thurner Compression	No swelling or VT: no follow-up
Nutcracker Compression	No proteinuria, hypertension, hematuria: no follow-up
VT	Acute: further investigation (modality varies) Chronic: no further imaging
Dilated Pelvic Veins in Females	Consider pelvic congestion syndrome Asymptomatic: No follow-up

VT = venous thrombosis