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Abstract Intracranial aneurysm rupture causes life-threatening sub-arachnoid hemorrhage. Current endovascular devices like coils, flow diverters, and intravascular implants aim to thrombose the aneurysm but have limitations and varying success rates depending on aneurysm characteristics. We propose a new computational framework integrating CFD and topology optimization to design personalized aneurysm implants. The optimization problem aims to reduce blood flow velocity within the aneurysm while ensuring adequate structural integrity of the implant. The fluid dynamics are governed by the Navier-Stokes equations, while the solid mechanics are described by the linear elasticity equations. A Darcy-Brinkman model is employed to simulate flow through the porous implant in the fluid domain, while the Solid Isotropic Material with Penalization (SIMP) method is used to interpolate between solid and void regions in the structural domain during topology optimization. The objective combines fluid energy dissipation ratio and solid strain energy with spatially varying weights. Global and local volume constraints generate personalized implants with porosity and flow-diverting architectures. The approach is demonstrated on patient-specific aneurysm geometries from rotational angiography. This CFD-driven topology optimization method enables personalized aneurysm implant design to potentially improve occlusion rates and reduce complications compared to current devices. Further studies will validate the optimized designs and investigate their efficacy in vitro and in vivo.