Whether the source of thegeometry is from interpolated imaging data or instantiateddirectly by a designer, the use of CAD infrastructure iscritical for creating and editing any geometric model. Ashelpful as purpose-built vascular modeling utilities such asVMTK and pyformex are, without CAD integration theysuffer from needlessly recreating and supporting CAD functionality without an optimized geometric-modelingcore that is regularly updated and enhanced by specialists