CEVAR: Centerline Embedding Extraction for Endovascular Aneurysm Repair
For clinicians monitoring EVAR patients, this provides a fully automatic, protocol-driven alternative to manual or semi-automatic centerline editing, reducing operator burden.
CEVAR automates centerline extraction and sealing zone assessment for endovascular aneurysm repair follow-up, outperforming a commercial semi-automatic workflow on both full and no-contrast CT test sets.
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.