Within the medical imaging community, 3D models of anatomical structures are now widely used in order to establish more accurate diagnoses than those based on 2D images. Many research works focus on an automatic process to build such 3D models. However automatic reconstruction induces many artifacts if the anatomical structure exhibits tortuous and thin parts (such as vascular networks) and the correction of these artifacts involves 3D-modeling skills and times that radiologists do not have. This article presents a semi-automatic approach to build a correct topology of vascular networks from 3D medical images. The user interface is based on sketching; user strokes both defines a command and the part of geometry where the command is applied to. Moreover the user-gesture speed is taken into account to adjust the command: a slow and precise gesture will correct a local part of the topology while a fast gesture will correct a larger part of the topology. This allows to correct the anatomical aberrations or ambiguities that appear on the segmented model in a few strokes.