Interventional neuroradiology is a growing field of minimally invasive therapies that includes embolization of aneurysms and arteriovenous malformations, carotid angioplasty and carotid stenting, and acute stroke therapy. Treatment is performed using image-guided instrument navigation through the patient's vasculature and requires intricate combination of visual and tactile coordination. In this paper we present a series of techniques for real-time high-fidelity simulation of angiographic studies. We focus in particular on the computation and visualization of blood flow and blood pressure distribution patterns, mixing of blood and contrast agent, and high-fidelity simulation of fluoroscopic images.