CT Vascular
CTNICE NG1562020NICE NG1282019, updated 2022 (Replaces CG68)NICE CG1472012, updated 2020WSES Guidelinesv2.0 · March 2026
Varies
EDInpatientOutpatient
All imaging requests must be justified by an IR(ME)R practitioner (radiologist or radiographer)Abdominal aortic aneurysm (NG156)
— ANY of the following
- Bedside USS first for suspected symptomatic/ruptured AAANICE NG156 Rec 1.2.1
- CTA for elective AAA repair evaluationNICE NG156 Rec 1.3.2
- Post-EVAR: colour duplex USS first-lineNICE NG156 Rec 1.7.3
- Post-EVAR: CTA for USS concernsNICE NG156 Rec 1.7.5
- Surveillance: ≥5.5 cm → refer within 2 weeks; 4.5–5.4 cm → 12 weeks + 3-monthly USS; 3.0–4.4 cm → USS
Carotid stenosis (NG128)
— ANY of the following
- Carotid imaging for all TIA/stroke patients who are endarterectomy candidatesNICE NG128 Rec 1.2.3
- Duplex USS first-line; CTA or MRA for confirmation
- Symptomatic stenosis 50–99% NASCET: urgent endarterectomy referral
Peripheral arterial disease (CG147)
— ANY of the following
- Duplex USS first-lineNICE CG147
- CE-MRA preferred second-lineNICE CG147 Rec 1.4.2
- CTA if MRA contraindicatedNICE CG147 Rec 1.4.3
- ABPI <0.9 indicates PAD
Acute mesenteric ischaemia — ED
— ANY of the following
- No specific NICE guideline — guideline gap
- Urgent CTA (arterial + portal venous) first-line — WSESWSES
- Mortality 30–90% untreated
Notes
Information
USS first for AAA before CTA
Information
Duplex USS first-line for carotid and PAD
Warning
Acute mesenteric ischaemia mortality 30–90% — justify on clinical urgency
Radiation Dose
CTA aorta ~10–15 mSv. CTA carotids ~3–5 mSv.
Guideline Corrections
NG186 → CG147 (2012, updated 2020)
NG186 is a COVID-19 VTE guideline, NOT a PAD guideline. Correct PAD guideline is CG147.
Change Log
v1.02026-03-05CT Aorta initial publication
v2.02026-03-08Expanded to include AAA pathway, carotid, PAD, mesenteric ischaemia. NG186 correction added.