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VOI C-arm CT images were obtained in 28 patients undergoing endovascular treatment of intracranial aneurysms and the VOI images were reconstructed by using a novel prototype reconstruction algorithm to minimize truncation artifacts from double collimation. The reconstruction accuracy of VOI C-arm CT images was assessed quantitatively by comparing them with the full-head noncollimated images. Quality of VOI C-arm CT images was comparable with that of the standard Feldkamp, Davis, and Kress reconstruction of noncollimated C-arm CT images. The authors conclude that VOI imaging allows multiple 3D C-arm CT acquisitions and provides information related to device expansion, parent wall apposition, and neck coverage during the procedure, with very low additional radiation exposure to the patient.