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In cardiac interventions, localization of guiding catheter tip in 2D fluoroscopic images is important to specify vessel branches and calibrate vessels with stenosis. While detection of guiding catheter tip is not trivial in contrast-free images due to low dose radiation as well as occlusion by other devices, it is even more challenging in contrast-filled images. As contrast-filled vessels become visible in X-ray imaging, the landmark of guiding catheter tip can often be completely occluded by the contrast medium. It is difficult even for human eyes to precisely localize the catheter tip from a single angiography image. Physicians have to rely on information before the inject of contrast medium to localize the guiding catheter tip occluded by contrast medium. Automatic landmark detection when occlusion happens is important and can significantly simplify the intervention workflow. To address this problem, we propose a novel …