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The endovascular coil embolisation of intracranial saccular aneurysms requires a set of specific X-ray images with which to view the aneurysm during coiling. These two-dimensional images, known as working projections should be optimal for measuring the aneurysm sac diameter, inserting the first coil, and checking coil overhang into the surrounding vessels. At present the gantry angle that produces these images is found by the radiologist by trial and error. In this paper we present a method for automatically finding the angles that will produce the desired X-ray projections. Our method consists of four steps: (1) segmenting the vasculature from three-dimensional angiographic data; (2) locating the aneurysm neck; (3) labelling the aneurysm sac; and (4) determining the optimal angle for viewing the aneurysm during coiling. We discuss details of the algorithm steps and present the results of the algorithm applied to one synthetic and two pathological examples.

Automatically finding optimal working projections for the endovascular coiling of intracranical aneurysms