Incidental Aortic / Iliac Aneurysm
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ACR IFC 2013 · SVS 2018 intervals·reviewed 2026-07-02
- •Diameter should be the maximum outer-wall-to-outer-wall measurement, ideally on a plane orthogonal to the vessel centerline (axial can overestimate a tortuous aorta).
- •Regardless of the size branch: rapid growth (>0.5 cm in 6 months or >1 cm in 1 year), a saccular contour, or symptoms (pain, tenderness) all warrant prompt vascular surgery referral.
- •Repair threshold is sex-specific: ≥5.5 cm in men, ≥5.0 cm in women.
Which vessel?
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Sources
- Khosa F, et al. Managing Incidental Findings on Abdominal and Pelvic CT and MRI, Part 2: White Paper of the ACR IFC II on Vascular Findings. J Am Coll Radiol. 2013;10(10):789-794.
- Chaikof EL, et al. The Society for Vascular Surgery Practice Guidelines on the Care of Patients with an Abdominal Aortic Aneurysm. J Vasc Surg. 2018;67(1):2-77.
Educational reference for clinicians — not medical advice. Verify against the primary source before acting on it; guidelines change. Final decisions rest with the interpreting physician and your institution's protocols.