Abstract: Methods and apparatus provide realistic training in endovascular and endoluminal procedures. One embodiment includes modeling accurately the tubular anatomy of a patient to enable optimized simulation. One embodiment includes simulating the interaction between a flexible device and the anatomy and optimizing the computation. One embodiment includes replicating the functionality of therapeutic devices, e.g. stents, and simulating their interaction with anatomy. One embodiment includes computing hemodynamics inside the vascular model. One embodiment includes reproducing visual feedback, using synthetic X-ray imaging and/or or visible light rendering. One embodiment includes generating contrast agent injection and propagation through a tubular network. One embodiment includes reproducing aspects of the physical environment of an operating room by simulating or tracking, such as C-arm control panel, foot pedals, monitors, real catheters and guidewires, etc.