Darren B. Orbach, MD, PhD
Chief, Neurointerventional Radiology; Co-Director, Cerebrovascular Surgery and Interventions Center; Sage Schermerhorn Chair in Image-Guided Therapy
Associate Professor of Radiology, Harvard Medical School
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Darren B. Orbach, MD, PhD
Chief, Neurointerventional Radiology; Co-Director, Cerebrovascular Surgery and Interventions Center; Sage Schermerhorn Chair in Image-Guided Therapy
Associate Professor of Radiology, Harvard Medical School
Medical Services
Languages
English
Education
Undergraduate School
Princeton University
1989
Princeton
NJ
US
Graduate School
The Rockefeller University
New York
NY
US
Medical School
Cornell University Medical College ,
1998
New York
NY
US
Internship
NYU Medical Center
1999
New York
NY
US
Residency
NYU Medical Center
1999
New York
NY
US
Fellowship
Diagnostic and Interventional Neuroradiology
NYU Medical Center
2005
New York
NY
US
Fellowship
Neurointerventional Radiology
NYU Medical Center
2006
New York
NY
US
Media
Caregiver Profile
Meet Dr. Darren Orbach
Certifications
American Board of Radiology (Diagnostic Radiology)
American Board of Radiology (Neuroradiology)
Professional History
I see patients in the relatively new subspecialty of pediatric neurointerventional radiology, an area in which we at Boston Children's Hospital have built one of the world’s largest and most comprehensive practices. My focus has been on children with neurovascular diseases and some cancers affecting the head and neck, using unique, guided approaches for treatment. I am passionate about making these novel treatment approaches, pionered for use in adults, available to children.
I am dual-trained as both a physician and scientist, having obtained my medical degree from Cornell University Medical College and my doctorate from Rockefeller University, in the Laboratory of Biophysics and Neurophysiology. At New York University Medical Center, I completed residencies in neurology and diagnostic radiology and fellowships in diagnostic and interventional neuroradiology.
In my role as a leader of the hospital's Cerebrovascular Surgical and Interventions Center, I see children with conditions affecting blood vessels in and around the brain and the spine. I have worked closely with colleagues from Neurosurgery and Neurology to build an internationally recognized multidisciplinary group that tightly integrates all aspects of clinical care and outcomes research.
In children with intracranial and extracranial vascular anomalies, we have pioneered the use of devices developed for adults, often in creative ways different from their original designed purpose. We create precision 3D models of patients’ brains and blood vessels using data from their brain scans to help us plan procedures. We have demonstrated that it is possible to achieve high-quality image-guided treatment at low radiation doses. And new techniques are allowing us to safely access arteries even in the youngest patients.
In addition, I treat patients with head and neck solid tumors, primarily retinoblastoma, at Boston Children’s Hospital and the Dana Farber Institute. Colleagues and I are exploring how we can further adapt techniques currently used in adults to help children with solid tumors, both for primary and secondary treatment, and for palliative treatment.
Approach to Care
decided that I wanted to be a doctor when I was very young, early in elementary school.
Also at an early age, I became very interested in the brain and how it works, how it is responsible for all those traits that make us human, and how it makes each of us into a unique individual.
I became so interested in those questions that as an undergraduate at Princeton University, I studied science and philosophy, with an emphasis on the philosophy of the mind and neuroscience. At one point, I thought I would be a pure researcher, and almost decided against medical school, but became convinced that some of the best research opportunities are found in medicine.
I pursued an MD/PhD at Cornell and Rockefeller University, allowing me both to treat patients and pursue neuroscience. At Cornell, I stumbled upon a new field, neurointerventional radiology, and was lucky enough to be accepted to a unique residency and fellowship program at New York University that provided cross-training in the various specialties that contribute to the field.
As a physician and scientist, I continue to be motivated by these two parallel drives. On the one hand, there is nothing like the gratification that comes with helping a child through a potentially devastating situation and seeing him or her thrive. When an infant patient, who faced a critical condition and underwent successful treatment, walks into my office years later as a healthy school-age child, there’s a jolt of joy and pride that makes everything else pale in comparison. Additionally, the conditions we treat are so rare and tools we use so new, that we are often working in uncharted territory and creating novel treatment strategies. Working through that as a care team with my colleagues and with the parents is absolutely exhilarating.
At the same time, my early passion for research is still very much there. I am committed to research into brain function and am working on developing new tools to enable us to visualize brain activity as it happens, at high resolution. My dream is to someday find an imaging tool that can help answer some of the most subtle and complex questions about the language of the brain: how it encodes information, how it generates and recalls feelings, and how it makes us who we are.
Also at an early age, I became very interested in the brain and how it works, how it is responsible for all those traits that make us human, and how it makes each of us into a unique individual.
I became so interested in those questions that as an undergraduate at Princeton University, I studied science and philosophy, with an emphasis on the philosophy of the mind and neuroscience. At one point, I thought I would be a pure researcher, and almost decided against medical school, but became convinced that some of the best research opportunities are found in medicine.
I pursued an MD/PhD at Cornell and Rockefeller University, allowing me both to treat patients and pursue neuroscience. At Cornell, I stumbled upon a new field, neurointerventional radiology, and was lucky enough to be accepted to a unique residency and fellowship program at New York University that provided cross-training in the various specialties that contribute to the field.
As a physician and scientist, I continue to be motivated by these two parallel drives. On the one hand, there is nothing like the gratification that comes with helping a child through a potentially devastating situation and seeing him or her thrive. When an infant patient, who faced a critical condition and underwent successful treatment, walks into my office years later as a healthy school-age child, there’s a jolt of joy and pride that makes everything else pale in comparison. Additionally, the conditions we treat are so rare and tools we use so new, that we are often working in uncharted territory and creating novel treatment strategies. Working through that as a care team with my colleagues and with the parents is absolutely exhilarating.
At the same time, my early passion for research is still very much there. I am committed to research into brain function and am working on developing new tools to enable us to visualize brain activity as it happens, at high resolution. My dream is to someday find an imaging tool that can help answer some of the most subtle and complex questions about the language of the brain: how it encodes information, how it generates and recalls feelings, and how it makes us who we are.
Publications
Low-profile mechanical thrombectomy devices for large vessel occlusion in pediatric ischemic stroke. View Abstract
Are brain arteriovenous malformations congenital or developmental? Evidence from paediatric age data. View Abstract
Outcomes of arteriovenous malformations with single versus multiple draining veins: A multicenter study. View Abstract
Mediolateral Diameter of the Falcine Sinus as a Predictor of Clinical Outcomes in Fetal Vein of Galen Malformations. View Abstract
Spetzler-martin grade IV cerebral arteriovenous malformations in adult patients: a propensity-score matched analysis of resection and stereotactic radiosurgery. View Abstract
Spetzler-Martin grade I and II cerebral arteriovenous malformations: a propensity-score matched analysis of resection and stereotactic radiosurgery in adult patients. View Abstract
Seizure presentation and incidence-associated factors in treated cerebral arteriovenous malformations: a secondary analysis of the MISTA consortium. View Abstract
Outcomes of arteriovenous malformation patients with multiple versus single feeders: A multicenter retrospective study with propensity-score matching. View Abstract
Efficacy and safety of preoperative embolization in surgical treatment of brain arteriovenous malformations: a multicentre study with propensity score matching. View Abstract
Cerebrovascular Anomalies in the Fetus. View Abstract
Comparing stand-alone endovascular embolization versus stereotactic radiosurgery in the treatment of arteriovenous malformations with Spetzler-Martin grades I-III: a propensity score matched study. View Abstract
Infantile dural arteriovenous fistula: a reconsideration. View Abstract
A comparative analysis of microsurgical resection versus stereotactic radiosurgery for Spetzler-Martin grade III arteriovenous malformations: A multicenter propensity score matched study. View Abstract
Symptoms Do Not Predict White Matter Injury in the Watershed Regions in Children with Moyamoya. View Abstract
Comparing Vascular Morphology and Hemodynamics in Patients with Vein of Galen Malformations Using Intracranial 4D Flow MRI. View Abstract
Introduction: Neurovascular Diseases across the Pediatric Age Spectrum. View Abstract
Prenatal treatment of a vein of Galen malformation by embolization and 1-year follow-up. View Abstract
Management of Choroid Plexus Tumors and the Benefit of Preoperative Embolization in Pediatric Patients: Report of 46 Cases from a Single Institution. View Abstract
Mutation of key signaling regulators of cerebrovascular development in vein of Galen malformations. View Abstract
Posterior cerebral territory ischemia in pediatric moyamoya: Surgical techniques and long-term clinical and radiographic outcomes. View Abstract
Editorial: Vein of galen malformation: a scientific and clinical journey targeting the best outcome. View Abstract
Direct Transverse Sinus Puncture for Transvenous Coil Embolization of Vein of Galen Malformations: Innovating Existing Techniques. View Abstract
Understanding development of jugular bulb stenosis in vein of galen malformations: identifying metrics of complex flow dynamics in the cerebral venous vasculature of infants. View Abstract
World federation of interventional and therapeutic neuroradiology (WFITN) federation assembly neurointerventional surgery safety checklist. View Abstract
Transuterine Ultrasound-Guided Fetal Embolization of Vein of Galen Malformation, Eliminating Postnatal Pathophysiology. View Abstract
World Federation of Interventional and Therapeutic Neuroradiology (WFITN) Federation Assembly neurointerventional surgery safety checklist. View Abstract
Neurosurgical outcomes of pediatric cerebral venous sinus thrombosis following acute mastoiditis: a systematic review and meta-analysis. View Abstract
Heart Failure Following Sinus Venosus Defect Closure in a Patient With Vein of Galen Malformation. View Abstract
Pulmonary Hypertension in Infants and Children with Vein of Galen Malformation and Association with Clinical Outcomes. View Abstract
Genetic dysregulation of an endothelial Ras signaling network in vein of Galen malformations. View Abstract
Diffusion-Weighted Magnetic Resonance Imaging Demonstrates White Matter Alterations in Watershed Regions in Children With Moyamoya Without Stroke or Silent Infarct. View Abstract
Magnetic Resonance Imaging/Angiography Versus Catheter Angiography for Annual Follow-up of Pediatric Moyamoya Patients: A Cost Outcomes Analysis. View Abstract
Overcoming roadblocks in clinical innovation via high fidelity simulation: use of a phantom simulator to achieve FDA and IRB approval of a clinical trial of fetal embolization of vein of Galen malformations. View Abstract
The case against endovascular thrombectomy in neonates with arterial ischemic stroke. View Abstract
Percutaneous transuterine fetal cerebral embolisation to treat vein of Galen malformations at risk of urgent neonatal decompensation: study protocol for a clinical trial of safety and feasibility. View Abstract
Standard umbilical artery catheters used as diagnostic and neurointerventional guide catheters in the treatment of neonatal cerebrovascular malformations. View Abstract
Cerebrospinal fluid leak in epidural venous malformations and blue rubber bleb nevus syndrome. View Abstract
Ivy sign: a diagnostic and prognostic biomarker for pediatric moyamoya. View Abstract
Intracranial venous malformation masquerading as a meningioma in PI3KCA-related overgrowth spectrum disorder. View Abstract
Low profile sheaths in pediatric neurointervention: a multicenter experience. View Abstract
DIAPH1 Variants in Non-East Asian Patients With Sporadic Moyamoya Disease. View Abstract
Long-term clinical and radiographic outcomes after pial pericranial dural revascularization: a hybrid surgical technique for treatment of anterior cerebral territory ischemia in pediatric moyamoya disease. View Abstract
Endovascular Intervention for Refractory Pediatric Cerebral Venous Sinus Thrombosis. View Abstract
Pediatric diagnostic cerebral angiography: practice recommendations from the SNIS Pediatric Committee. View Abstract
Non-invasive Urinary Biomarkers in Moyamoya Disease. View Abstract
Contemporary Management of Vascular Anomalies of the Head and Neck-Part 1: Vascular Malformations: A Review. View Abstract
Intra-arterial chemotherapy for rhabdomyosarcoma. View Abstract
Vein of Galen Malformation. View Abstract
Adverse effects of erenumab on cerebral proliferative angiopathy: A case report. View Abstract
Intracranial venous malformations: Incidence and characterization in a large pediatric cohort. View Abstract
Congenital Disseminated Pyogenic Granuloma: Characterization of an Aggressive Multisystemic Disorder. View Abstract
COVID-19 and neurointerventional service worldwide: a survey of the European Society of Minimally Invasive Neurological Therapy (ESMINT), the Society of NeuroInterventional Surgery (SNIS), the Sociedad Iberolatinoamericana de Neuroradiologia Diagnostica y Terapeutica (SILAN), the Society of Vascular and Interventional Neurology (SVIN), and the World Federation of Interventional and Therapeutic Neuroradiology (WFITN). View Abstract
Dysregulation of the EphrinB2-EphB4 ratio in pediatric cerebral arteriovenous malformations is associated with endothelial cell dysfunction in vitro and functions as a novel noninvasive biomarker in patients. View Abstract
Microsurgical Ligation of Residual Fistulous Arteriovenous Shunt From a Radicular Artery to a Thoracic Arteriovenous Malformation: 2-Dimensional Operative Video. View Abstract
Clinical status and evolution in moyamoya: which angiographic findings correlate? View Abstract
Survey of practice patterns and preparedness for endovascular therapy in acute pediatric stroke. View Abstract
Multidisciplinary management of spinal aneurysmal bone cysts: A single-center experience. View Abstract
Moyamoya syndrome and PHACE syndrome: clinical and radiographic characterization of the intracranial arteriopathy and response to surgical revascularization. View Abstract
Reversible intracranial hypertension following treatment of an extracranial vascular malformation: case report. View Abstract
Mutations in Chromatin Modifier and Ephrin Signaling Genes in Vein of Galen Malformation. View Abstract
Acute fatal hemorrhage from previously undiagnosed cerebral arteriovenous malformations in children: a single-center experience. View Abstract
Human genetics and molecular mechanisms of vein of Galen malformation. View Abstract
Multimodal treatment approach in a patient with multiple intracranial myxomatous aneurysms. View Abstract
Imaging features and prognostic factors in fetal and postnatal torcular dural sinus malformations, part II: synthesis of the literature and patient management. View Abstract
Imaging features and prognostic factors in fetal and postnatal torcular dural sinus malformations, part I: review of experience at Boston Children's Hospital. View Abstract
Segmental upper mid-basilar artery sacrifice in a child using a Micro Vascular Plug device for treatment of a basilar arteriovenous fistula compressing the brainstem. View Abstract
Malignant glomus tumors of the head and neck in children and adults: Evaluation and management. View Abstract
Segmental upper mid-basilar artery sacrifice in a child using a Micro Vascular Plug device for treatment of a basilar arteriovenous fistula compressing the brainstem. View Abstract
RF Heating of Gold Cup and Conductive Plastic Electrodes during Simultaneous EEG and MRI. View Abstract
PHACE Syndrome: Consensus-Derived Diagnosis and Care Recommendations. View Abstract
Mechanical thrombectomy for pediatric acute ischemic stroke: review of the literature. View Abstract
Considerations in Applying a New Stent Retriever in Pediatric Endovascular Cerebral Thrombectomy for Acute Ischemic Stroke. View Abstract
Direct neural current imaging in an intact cerebellum with magnetic resonance imaging. View Abstract
Interventional neuroradiology in children: diagnostics and therapeutics. View Abstract
The natural history of cerebral cavernous malformations in children. View Abstract
Pediatric central nervous system vascular malformations. View Abstract
Optimizing cerebrovascular surgical and endovascular procedures in children via personalized 3D printing. View Abstract
Safety of neuroangiography and embolization in children: complication analysis of 697 consecutive procedures in 394 patients. View Abstract
Lower vertebral-epidural spinal arteriovenous fistulas: a unique subtype of vertebrovertebral arteriovenous fistula, treatable with coil and Penumbra Occlusion Device embolization. View Abstract
Intracranial aneurysms in the youngest patients: characteristics and treatment challenges. View Abstract
Retinoblastoma. View Abstract
Microsurgical treatment of arteriovenous malformations in pediatric patients: the Boston Children's Hospital experience. View Abstract
Magnetic resonance imaging of ionic currents in solution: the effect of magnetohydrodynamic flow. View Abstract
Complications of intra-arterial chemotherapy for retinoblastoma. View Abstract
Blue toe syndrome: a complication of intra-arterial technique, not intra-arterial chemotherapy for retinoblastoma. View Abstract
Transarterial embolization of mandibular arteriovenous malformations using ONYX. View Abstract
Neurointerventions in children: radiation exposure and its import. View Abstract
Intra-arterial chemotherapy for group C retinoblastoma with adjacent high-flow infantile hemangioma. View Abstract
Re: The influence of angioarchitecture on management of pediatric intracranial arteriovenous malformations. View Abstract
Addressing challenges in 4 F and 5 F arterial access for neurointerventional procedures in infants and young children. View Abstract
Incorporating reversible and irreversible transverse relaxation effects into Steady State Free Precession (SSFP) signal intensity expressions for fMRI considerations. View Abstract
Imaging characteristics of cerebrovascular arteriopathy and stroke in Hutchinson-Gilford progeria syndrome. View Abstract
Endovascular therapy in children with acute ischemic stroke: review and recommendations. View Abstract
Cerebrofacial venous anomalies, sinus pericranii, ocular abnormalities and developmental delay. View Abstract
Angioarchitectural features associated with hemorrhagic presentation in pediatric cerebral arteriovenous malformations. View Abstract
Dural arteriovenous fistulae in pediatric patients: associated conditions and treatment outcomes. View Abstract
Pial arteriovenous fistulae in pediatric patients: associated syndromes and treatment outcome. View Abstract
Long-term outcome of radiofrequency ablation for intraoral microcystic lymphatic malformation. View Abstract
Increased vertebral artery tortuosity index is associated with adverse outcomes in children and young adults with connective tissue disorders. View Abstract
Stretched and sheared microcatheter retained after onyx embolization of infantile myofibromatosis. View Abstract
An empirical investigation of motion effects in eMRI of interictal epileptiform spikes. View Abstract
Trigeminocardiac reflex in a child during pre-Onyx DMSO injection for juvenile nasopharyngeal angiofibroma embolization. A case report. View Abstract
Safety and clinical efficacy of Onyx for embolization of extracranial head and neck vascular anomalies. View Abstract
Complex spinal-paraspinal fast-flow lesions in CLOVES syndrome: analysis of clinical and imaging findings in 6 patients. View Abstract
Management of arteriovenous malformations. View Abstract
Fast human brain magnetic resonance responses associated with epileptiform spikes. View Abstract
Klippel-Trenaunay syndrome and spinal arteriovenous malformations: an erroneous association. View Abstract
A novel association between RASA1 mutations and spinal arteriovenous anomalies. View Abstract
The use of Onyx for embolization of central nervous system arteriovenous lesions in pediatric patients. View Abstract
Neurointerventional management of low-flow vascular malformations of the head and neck. View Abstract
Neurointerventional management of high-flow vascular malformations of the head and neck. View Abstract
Infantile hemangiomas involving the neuraxis: clinical and imaging findings. View Abstract
Arteriovenous shunting as a new feature of PHACES. Case report. View Abstract
Traumatic dissecting aneurysm at the vertebrobasilar junction in a 3-month-old infant: evaluation and treatment strategies. Case report. View Abstract
Re: Spinal epidural hemangiomas: various types of MR imaging features with histopathologic correlation. View Abstract
Comparing real-world advantages for the clinical neuroradiologist between a high field (3 T), a phased array (1.5 T) vs. a single-channel 1.5-T MR system. View Abstract
Carotid artery stent implantation: evaluation with multi-detector row CT angiography and virtual angioscopy--initial experience. View Abstract
Correlation of apparent diffusion coefficient with neuropsychological testing in temporal lobe epilepsy. View Abstract
Isolated foot weakness caused by a parasagittal metastatic parotid adenocarcinoma. View Abstract
Surgical treatment of multifocal epilepsy involving eloquent cortex. View Abstract
Psychogenic, nonepileptic seizures associated with video-EEG-verified sleep. View Abstract
Multiple subpial transection for intractable partial epilepsy: an international meta-analysis. View Abstract
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