A medical simulation apparatus may include a housing, a vessel simulating tube carried by the housing, a liquid reservoir carried by the housing, a pump carried by the housing for circulating the liquid from the liquid reservoir through the vessel simulating tube, and an access port in fluid connection with the vessel simulating tube for receiving an instrument therein. The pump may be a pulsatile pump for providing a pulsed liquid circulation simulating blood flow. Also, the vessel simulating tube may include an elastic material (e.g., silicone) expandable with the pulsed liquid circulation. Furthermore, the vessel simulating tube may include a portion having an enlarged diameter simulating an aneurysm, or it may include a portion having a restriction simulating a stenosis. Alternately, the vessel simulating tube may include a portion simulating an arteriovenous malformation or tumor.