CEVAR: Centerline Embedding Extraction for Endovascular Aneurysm Repair
Authors: Roman Naeem, Timo Niiniskorpi, Charlotte Sandström, Naman Desai, Anders Jeppsson, Ida Häggström, Fredrik Kahl, Håkan Roos, +1 more
Organizations: Chalmers University of Technology, 412 96 Gothenburg, Sweden · The University of Gothenburg, 405 30 Gothenburg, Sweden · Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
Long-term mortality rates after endovascular aneurysm repair (EVAR) remain elevated due to post-EVAR rupture caused by loss of seal in stent graft sealing zones. Structured CT review using centerline measurements improves detection, but current workflows require manual centerline editing and expert operators. We propose a transformer framework for automated, protocol-driven sealing zone assessment that combines 3D centerline tracking with embedding-based geometric prediction. Two state-of-the-art image-to-graph models are evaluated for aorto-iliac centerline extraction from follow-up CT and for measurement of stent position, vessel diameters, and seal lengths according to EVAR4C protocol. Across the full test set and a challenging no-contrast subset, the proposed fully automatic method outperforms the commercial semi-automatic workflow.