Accurate segmentation of vascular structures in coronary angiography remains a core challenge in medical image analysis due to the complexity of elongated, thin, and low-contrast vessels. Classical convolutional neural networks (CNNs) often fail to preserve topological continuity, while recent Vision Transformer (ViT)-based models, although strong in global context modeling, lack precise boundary awareness. In this work, we introduce BAVT, a Boundary-Aware Vision Transformer, a ViT-based architecture enhanced with an edge-aware loss that explicitly guides the segmentation toward fine-grained vascular boundaries. Unlike hybrid transformer-CNN models, BAVT retains a minimal, scalable structure that is fully compatible with large-scale vision foundation model (VFM) pretraining. We validate our approach on the DCA-1 coronary angiography dataset, where BAVT achieves superior performance across medical image segmentation metrics outperforming both CNN and hybrid baselines. These results demonstrate the effectiveness of combining plain ViT encoders with boundary-aware supervision for clinical-grade vascular segmentation.
Hezil et al. (Sun,) studied this question.