Follow-up of a Patient with an Abdominal Aortic Aneurysm

A 72-year-old male with a known abdominal artery aneurysm (AAA) (4.2cm diameter) presents to his physician for his annual aneurysm duplex ultrasound. He also complains of left leg pain and a tingling sensation for the last 2 weeks. Additionally, he reports that he has felt a "beating" sensation behind his left knee during bathing this morning. The patient's past medical history includes hypertension, hyperlipidemia and diabetes mellitus. He does not drink alcohol, or use illicit drugs, but he smokes two packs of cigarettes per day for the past 40 years. His vital signs are within normal limits. Aside from a small palpable pulsatile mass in the left popliteal fossa, the rest of physical examination is unremarkable.

What is best next step in management of the patient's symptoms?

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