Semiautomated centerline analysis for planning endovascular repair of the aortic arch

Because vascular surgical techniques are constantly being refined and hybrid procedures are developing, aortic lesions involving the aortic arch are increasingly being treated with endovascular aortic repair. Since individual pathomorphology represents a crucial criterion regarding the applicability of endovascular techniques, sophisticated evaluation of radiological imaging is necessary to gain quantitative anatomical information. Centerline analysis represents a semiautomated image postprocessing algorithm that calculates the geometric vessel center and allows diameter as well as distance measurements along its course. Thus, data provided by centerline analysis are beneficial for therapy stratification, patient selection, and treatment planning. Using clinical case reports, this review aims to demonstrate the potential of centerline analysis for preoperative evaluation of aortic arch lesions and critically discusses the advantages and disadvantages of this technique.