# Real-Time Pulsatile Flow Prediction for Realistic, Diverse Intracranial Aneurysm Morphologies using a Graph Transformer and Steady-Flow Data Augmentation

arXiv: https://arxiv.org/abs/2601.19876 · HTML: https://mlsanity.com/paper/2601.19876/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 12 of its 29 references that are in the map.
- First posted on arXiv 27 Jan 2026.

## Builds on (most cited first, 12 of 12)

- [How Powerful are Graph Neural Networks?](https://mlsanity.com/paper/1810.00826/) (2018)
- [Strategies for Pre-training Graph Neural Networks](https://mlsanity.com/paper/1905.12265/) (2019)
- [Learning Mesh-Based Simulation with Graph Networks](https://mlsanity.com/paper/2010.03409/) (2020)
- [Recipe for a General, Powerful, Scalable Graph Transformer](https://mlsanity.com/paper/2205.12454/) (2022)
- [A Generalization of Transformer Networks to Graphs](https://mlsanity.com/paper/2012.09699/) (2020)
- [LaB-GATr: geometric algebra transformers for large biomedical surface and volume meshes](https://mlsanity.com/paper/2403.07536/) (2024)
- [Mesh convolutional neural networks for wall shear stress estimation in 3D artery models](https://mlsanity.com/paper/2109.04797/) (2021)
- [Explicit Differentiable Slicing and Global Deformation for Cardiac Mesh Reconstruction](https://mlsanity.com/paper/2409.02070/) (2024)
- [Deep vectorised operators for pulsatile hemodynamics estimation in coronary arteries from a steady-state prior](https://mlsanity.com/paper/2410.11920/) (2024)
- [Two-Stage Generative Model for Intracranial Aneurysm Meshes with Morphological Marker Conditioning](https://mlsanity.com/paper/2505.10407/) (2025)
- [Wall Shear Stress Estimation in Abdominal Aortic Aneurysms: Towards Generalisable Neural Surrogate Models](https://mlsanity.com/paper/2507.22817/) (2025)
- [GReAT: leveraging geometric artery data to improve wall shear stress assessment](https://mlsanity.com/paper/2508.19030/) (2025)

## Abstract (arXiv)

Extensive studies suggested that fluid mechanical markers of intracranial aneurysms (IAs) derived from Computational Fluid Dynamics (CFD) can indicate disease progression risks, but to date this has not been translated clinically. This is because CFD requires specialized expertise and is time-consuming and low throughput, making it difficult to support clinical trials. A deep learning model that maps IA morphology to biomechanical markers can address this, enabling physicians to obtain these markers in real time without performing CFD. Here, we show that a Graph Transformer model that incorporates temporal information, which is supervised by large CFD data, can accurately predict Wall Shear Stress (WSS) across the cardiac cycle from IA surface meshes. The model effectively captures the temporal variations of the WSS pattern, achieving a Structural Similarity Index (SSIM) of up to 0.981 and a maximum-based relative L2 error of 2.8%. Ablation studies and SOTA comparison confirmed its optimality. Further, as pulsatile CFD data is computationally expensive to generate and sample sizes are limited, we engaged a strategy of injecting a large amount of steady-state CFD data, which are extremely low-cost to generate, as augmentation. This approach enhances network performance substantially when pulsatile CFD data sample size is small. Our study provides a proof of concept that temporal sequences cardiovascular fluid mechanical parameters can be computed in real time using a deep learning model from the geometric mesh, and this is achievable even with small pulsatile CFD sample size. Our approach is likely applicable to other cardiovascular scenarios.