Abstract. Saccular aneurisms, swelling of a blood vessel, are investigated in order (i) to estimate the development risk of the wall lesion, before and after intravascular treatment, assuming that the pressure is the major factor, and (ii) to better plan medical interventions. Numerical simulations, using the finite element method, are performed in three-dimensional aneurisms. Computational meshes are derived from medical imaging data to take into account both between-subject and within-subject anatomical variability of the diseased vessel segment. The 3D reconstruction is associated with a faceted surface. A geometrical model is then obtained to be finally meshed for a finite element use. The pulsatile flow of incompressible Newtonian blood is illustrated by numerical simulations carried out in two saccular aneurism types, a side-and a terminal-aneurism. High pressure zones are observed in the aneurism cavity, especially in the terminal one.Mathematics Subject Classification. 68U05, 68U10, 76D05, 35Q30, 65N30.