3D models for vascular lumen segmentation in MRA images and for artery-stenting simulation

Arterial stenoses and aneurysms are increasingly treated using stents. The goal of this work is to facilitate the pre-operative choice of the stent's length and diameter. Two models are used to accomplish this task: a deformable cylindrical simplex (DCS) model of the arterial intra-luminal wall and a right generalized cylinder (RGC) model representing the stent's geometrical properties. An angiographic 3D image is first segmented using the DCS model to create a patient-specific vascular model. The RGC model of a folded stent is then slid along the vessel centerline until an interactively chosen delivery location, and the model's geometry is modified to simulate the unfolding of the stent. Lastly, the DCS model is re-meshed to fit the shape of the unfolded-stent model and thus to simulate the shape of the arterial lumen boundaries after stenting. Accuracy of the segmentation was quantitatively evaluated in images of arterial phantoms with stenoses ranging from 50 to 95%. Mean error of the resulting diameter estimation was 4.24%. The simulation of the stent insertion is qualitatively illustrated using data of a patient with an aneurysm in the aorta arch.