Radiologist
41 years of experience
Video profile
Accepting new patients
Metrowest Medical Center
67 Union St
Natick, MA 01760
508-650-7333
Locations and availability (3)

Education ?

Medical School
University Of The Witwatersrand (1969)
Foreign school

Awards & Distinctions ?

Awards  
Castle Connolly's Top Doctors™ (2013)
Associations
American Board of Radiology
Society of Interventional Radiology

Affiliations ?

Dr. Sacks is affiliated with 8 hospitals.

Hospital Affilations

Score

Rankings

    • Currently 4 of 4 crosses
    Top 25%
  • Beth Israel Deaconess Medical Center
    330 Brookline Ave, Boston, MA 02215
    • Currently 4 of 4 crosses
    Top 25%
  • Metrowest Medical Center
    115 Lincoln St, Framingham, MA 01702
    • Currently 3 of 4 crosses
    Top 50%
  • Beth Israel Deaconess Hospital
  • Harvard Medical Faculty Physicians (HMFP) at Beth Israel Deaconess Medical Center
  • Section Chief, Interventional Radiology at Beth Israel Deaconess Medical Center
  • Needham Campus
  • Beth Israel Deaconess Medical Center - West Campus
    1 Deaconess Rd, Boston, MA 02215
  • Publications & Research

    Dr. Sacks has contributed to 33 publications.
    Title Embolotherapy for Lower Urinary Tract Hemorrhage.
    Date September 2009
    Journal Journal of Vascular and Interventional Radiology : Jvir
    Excerpt

    The patient characteristics, techniques used, and outcomes of 11 patients with lower urinary tract hemorrhage treated with embolotherapy are described. The authors focus on bilateral superselective embolization of the arterial supply to the bladder and techniques to embolize multiple small vessels supplying the bladder when the vascular anatomy is complicated and superselective catheterization is not possible. The immediate success rate was 100%, with three later recurrences. One procedure was complicated by asymptomatic occlusion of the posterior division of the internal iliac artery. Embolotherapy can provide at least short-term success adequate to improve quality of life for palliation with few complications.

    Title Noninvasive Vascular Imaging in the Diagnosis and Treatment of Adventitial Cystic Disease of the Popliteal Artery.
    Date November 1997
    Journal Journal of Vascular Surgery : Official Publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter
    Excerpt

    This brief case report describes the successful outcome after surgical excision of multiple adventitial cysts of the popliteal artery in a 75-year-old man with rapidly worsening claudication. It highlights several unsettled points concerning the diagnosis, cause, and management of cystic adventitial disease of the popliteal artery and compares duplex ultrasound, computed tomography, and magnetic resonance angiography in the noninvasive diagnosis and treatment of this condition.

    Title Strategies to Increase the Use of Autogenous Arteriovenous Fistula in End-stage Renal Disease.
    Date September 1997
    Journal Annals of Vascular Surgery
    Excerpt

    The purpose of this retrospective study was to review our experience with a consecutive group of end-stage renal disease (ESRD) patients using simple strategies to increase the use of autogenous vascular access, and determine whether the current trend of using synthetic bridge-graft fistula (BGF) rather than autogenous arteriovenous fistula (AVF), could be reversed, despite an aging population and broadening criteria for hemodialysis. All patients for vascular access surgery had careful preoperative clinical examination of the arm veins with outflow occlusion to determine the venous anatomy and continuity. Where no veins were apparent or their continuity in doubt, selective preoperative venography was performed. Where veins were unsatisfactory for forearm AVF, new or modified surgical procedures to use both the basilic and cephalic veins in the upper arm were performed. Intraoperative angioscopy was used to monitor vein quality and surgical technique. Ninety-eight primary vascular access procedures were performed in 76 patients, 75 (76.5%) AVF (forearm, n = 41; upper arm, n = 34) and 23 (23.5%) BGF. Forty-one of 76 (54%) had already had at least one previous access procedure prior to this study. More than one access procedure was needed in 16 patients. Preoperative venography was performed in 22 (22.4%) and intraoperative angioscopy in 45 (45.9%) of the 98 procedures. The number of revisions required to maintain patency was significantly higher for BGF (37 revisions in 14/23) than AVF (16 revisions in 13/75) (p < 0.0001, Poisson test) with an annualized secondary revision rate of 1.168 for BGF and 0.173 for AVF (p < 0.0001, Poisson test). AVF had both longer primary (p = 0.0001, log rank test) and secondary patency (p = 0.038, log rank test) than BGF. AVF as the primary vascular access can be significantly increased and the current trend of using BGF reversed with the use of simple clinical strategies to evaluate the suitability of the arm veins for vascular access.

    Title Fracture of an Iliac Artery Palmaz Stent.
    Date October 1996
    Journal Journal of Vascular and Interventional Radiology : Jvir
    Title Diagnosis of Parathyroid Adenomas: Efficacy of Measuring Parathormone Levels in Needle Aspirates of Cervical Masses.
    Date December 1994
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    The purpose of this study was to assess the value of measuring parathormone levels in percutaneous needle aspirates of suspicious cervical lesions in patients with hyperparathyroidism to confirm whether the lesion represents abnormal parathyroid tissue.

    Title Vena Caval Filter Placement Via the External Jugular Vein.
    Date October 1990
    Journal Ajr. American Journal of Roentgenology
    Title Arteriographic Ablation of Cervical Parathyroid Adenomas.
    Date December 1989
    Journal The Journal of Clinical Endocrinology and Metabolism
    Excerpt

    In some cases of primary hyperparathyroidism, in particular where neck exploration has been unsuccessful, an alternative to surgical therapy may be desirable. We studied the acute and chronic metabolic effects of attempted angiographic destruction by angiographic contrast infusion of solitary parathyroid adenomas in 18 patients with symptomatic disease. Fourteen patients had failed prior surgery; 4 patients had not undergone prior surgery but were extremely high surgical risks. Cervical adenomas were present in 17 of 18 subjects; mediastinal adenoma in 1 of 18. Sixteen patients underwent selective parathyroid venous catheterization, which facilitated subsequent arteriographic localization. Selective arteriographic localization and attempted angiographic ablation were performed in all subjects with standard contrast, renografin-60. Laboratory studies, including serum calcium and PTH, were frequently performed before and after attempted angiographic parathyroid ablation. In all patients serum calcium fell to normal or subnormal levels within 48 h of attempted ablation. Prolonged follow-up (mean, 35.1 months) revealed that ablation was curative in 12 of 18 (sustained normocalcemia) and partially effective in 1 of 18 patients. For the entire group serum calcium fell from 3.14 +/- 0.07 at presentation to 2.42 +/- 0.07 mmol/L at the end of follow-up (or before surgery in unsuccessful cases; P less than 0.001). In 4 of 5 failed cases hypercalcemia recurred within 2 weeks. All 5 failed cases underwent curative surgery, aided by accurate localization achieved during angiographic procedure. Several transient complications and 1 case of permanent hypoparathyroidism were noted. We conclude that angiographic ablation of cervical parathyroid adenomas can be considered as an extension of diagnostic angiographic procedures in selected cases of primary hyperparathyroidism who have failed prior surgery of possibly in rare cases where surgery is contraindicated.

    Title Monofilament Modification to the Carey-coons Stent.
    Date November 1989
    Journal Ajr. American Journal of Roentgenology
    Title An Internalized Double-j Catheter for Percutaneous Transgastric Cystogastrostomy.
    Date March 1989
    Journal Ajr. American Journal of Roentgenology
    Title Remote Biomedical Spectroscopic Imaging of Human Artery Wall.
    Date May 1988
    Journal Lasers in Surgery and Medicine
    Excerpt

    We discuss a general technique, laser spectroscopic imaging (LSI), remote acquisition of spectroscopic images of biological tissues and tissue conditions. The technique employs laser-induced spectroscopic signals, collected and transmitted via an array of optical fibers, to produce discrete pixels of information from which a map or image of a desired tissue characteristic is constructed. We describe a prototype LSI catheter that produces spectral images of the interior of human arteries for diagnosis of atherosclerosis. The diagnostic is based on the fact that normal artery wall and atherosclerotic plaque exhibit distinct fluorescence spectra in the 500-650 nm range when excited by 476-nm laser light; the fluorescence from blood is minimal. The catheter is composed of 19 optical fibers enclosed in a transparent, protective shield. Argon ion laser radiation is used for excitation, and an optical multichannel spectral analyzer is used for detection. Sequential sampling is used to minimize crosstalk among fibers and reduce blurring of the image. Computer-processed 19-pixel spectroscopic images are produced of fresh cadaver artery in vitro. Regions of normal tissue, plaque, and blood are identified, and the diagnoses are confirmed histologically and by direct spatial correlation. The results demonstrate the concept of using this laser catheter system for real-time imaging.

    Title Pancreatic Masses That Angiographically Simulate Intrasplenic Lesions.
    Date February 1986
    Journal Cardiovascular and Interventional Radiology
    Excerpt

    Major improvements in the resolving power of computed tomography and ultrasound over the last decade have greatly improved the preoperative evaluation of abdominal masses. Angiography is, however, still often required for vascular mapping and assistance in the differential diagnosis. Although the site of origin of an avascular, intrasplenic mass may be the spleen, our experience and review of the literature indicates that such primary or secondary splenic masses are relatively rare. A primary pancreatic mass often a pseudocyst is a more frequent cause and should figure prominently in the differential diagnosis.

    Title A Comparison of Hexabrix and Renografin 60 in Peripheral Arteriography.
    Date February 1985
    Journal Investigative Radiology
    Excerpt

    Fifty-one patients were analyzed after a randomized double-blind study comparing Hexabrix and Renografin 60 in peripheral arteriography. The arteriographic studies and the volumes of contrast material used in both groups were similar. Hexabrix caused significantly less pain and discomfort than Renografin 60, and the diagnostic quality of the radiographs was comparable. A slightly higher incidence of minor side effects was noted in the Hexabrix group, mostly nausea and vomiting and urinary retention.

    Title Catheter Hysterosalpingography.
    Date April 1984
    Journal Radiology
    Excerpt

    The authors describe a 5-F catheter which is simpler to use than the standard vacuum cannula when performing hysterosalpingography.

    Title A Nonoperative Technique for Establishment of a Gastrostomy in the Dog.
    Date January 1984
    Journal Investigative Radiology
    Excerpt

    Gastrostomies have been performed nonoperatively under local anaesthesia using a simultaneous percutaneous and endoscopic approach. This technique has been modified to be done under fluoroscopy without the need for endoscopy. The technique and results in five dogs are described.

    Title A Comparison of Hexabrix and Renografin 60 in Peripheral Arteriography.
    Date May 1983
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    Fifty-one patients were analyzed after a randomized double-blind study comparing Hexabrix and Renografin 60 in peripheral arteriography. The arteriographic studies and the volumes of contrast material used in both groups were similar. Hexabrix caused significantly less pain and discomfort than Renografin 60, and the diagnostic quality of the radiographs was comparable. A slightly higher incidence of minor side effects was noted in the Hexabrix group, mostly nausea and vomiting and urinary retention.

    Title Nonoperative Drainage of Fluid Collections Following Operations on the Biliary Tract.
    Date April 1983
    Journal Surgery, Gynecology & Obstetrics
    Title Internal Iliac Artery Vasopressin Infusion for Postpartum Hemorrhage.
    Date August 1982
    Journal American Journal of Obstetrics and Gynecology
    Title The Cervical Split: a Pseudofracture.
    Date June 1982
    Journal Skeletal Radiology
    Excerpt

    A horizontal lucent line projecting over a cervical vertebral body on lateral radiographs and simulating a fracture is described. The pseudofracture line results from the lucency between contiguous proliferative osteophytes at the uncinate process/vertebral articulation. Associated disc space narrowing was seen in all of our eleven cases. The origin of this pseudofracture line, cases illustrating this phenomenon, and additional projections helpful for clarification are presented.

    Title Reestablishment of a Percutaneous Jejunostomy.
    Date April 1982
    Journal Surgery
    Title Left Renal Venous Hypertension in Association with the Nutcracker Phenomenon.
    Date April 1982
    Journal Cardiovascular and Interventional Radiology
    Title Postoperative Abscess Drainage in Patients with Established Sinus Tracks or Drains.
    Date March 1982
    Journal Radiology
    Title Catheter/needle Assembly for Drainage of Fluid Collections.
    Date September 1981
    Journal Ajr. American Journal of Roentgenology
    Title Ovarian Hyperstimulation Syndrome.
    Date February 1981
    Journal Ajr. American Journal of Roentgenology
    Title Parathyroid Adenomas: Cinearteriography.
    Date October 1980
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    Parathyroid adenomas in an ectopic location, either the mediastinum or high in the neck, can be relatively easily identified arteriographically because the lesions are separate from the thyroid gland and therefore are not confused with it. However, in most cases in which the adenoma is situated adjacent to thyroid tissue (85%-90%), arteriographic identification, particularly when the lesion is small, may be extremely difficult. Cineangiography during parathyroid arteriography has been found extremely helpful in positive identification of these juxtathyroidal adenomas. Movement of the head from side to side and swallowing maneuvers during cine recording of a selective arteriogram allow determination of the location of a suspicious "blush" in relation to the thyroid gland. As a rule, parathyroid adenomas stain densely in the tissue phase, are nearly always posterior to the thyroid, and separate from thyroid tissue on swallowing. In 10 of 14 parathyroid arteriographic examinations, cinearteriography was useful in confirming or excluding a parathyroid adenoma.

    Title Caudate Lobe Resection to Reduce Inferior Vena Caval Hypertension Prior to Portacaval Shunt.
    Date June 1980
    Journal Surgery
    Excerpt

    Coexistent caval and portal hypertension was recognized on preoperative angiographic study of a patient with cirrhosis and variceal bleeding. This hemodynamic situation can preclude adequate reduction of portal hypertension by portasystemic shunt and can result in fatal postoperative bleeding. Resection of a very large caudate lobe effectively reduced caval pressure and allowed a direct solution to the problem by portacaval anastomosis, rather than by more complex shunts or by nonshunting procedures previously suggested as alternatives.

    Title Visualization of the Distal Arterial Vessels in Complete Aortic Occlusion.
    Date May 1980
    Journal Ajr. American Journal of Roentgenology
    Title Postoperative Percutaneous Kidney Stone Extraction.
    Date April 1980
    Journal Radiology
    Excerpt

    Retained stones may be found in patients who have undergone operations for multiple renal calculi. These stones often produce morbidity and must be removed. The authors describe a technique using a nephrostomy tube, placed during the initial operation, to extract stones percutaneously.

    Title A Safe Technique for Introduction of the Kimray-greenfield Filter.
    Date January 1980
    Journal Radiology
    Excerpt

    A modification in the introduction of the Kimray-Greenfield filter is described. Rather than advancing the stylet toward the Luer-lok assembly and thereby discharging the filter, the authors propose positioning the carrier containing the closed filter farther into the inferior vena cava, then withdrawing the catheter and carriage while holding the stylet in place. This method reduces the chance for damaging the caval wall.

    Title Use of the 1 Mm "j"-guidewire for Selective Catheterization.
    Date October 1979
    Journal Radiology
    Title Percutaneous Reestablishment of Feeding Gastrostomies.
    Date June 1979
    Journal Surgery
    Title Portal Vein Aneurysm.
    Date May 1979
    Journal Ajr. American Journal of Roentgenology
    Excerpt

    While there have been a few references to portal vein aneurysm in the world literature, this is the first report in United States radiologic literature. During a routine evaluation for fever in one patient, an ultrasound examination suggested this unusual entity at the junction of the splenic and superior mesenteric vein. It was later confirmed by angiography. Two other patients were being investigated angiographically for gastrointestinal bleeding when portal vein aneurysms were discovered. In contrast to the central location of the first patient's aneurysm, the latter two were more distal in the portal tree. The literature is reviewed and different etiologic hypothesis discussed.

    Title Metastatic Melanoma Presenting Clinically As Multiple Colonic Polyps.
    Date October 1977
    Journal Ajr. American Journal of Roentgenology
    Title Capsular Visualization in Lipohemarthrosis of the Knee.
    Date January 1977
    Journal Radiology
    Excerpt

    A new sign for the diagnosis of lipohemarthrosis on vertical beam lateral knee radiographs depends upon visualization of the joint capsule due to the presence of fat lying both within and outside of the joint. Recognition of lipohemarthrosis on routine knee radiographs may aid in the diagnosis of subtle tibial plateau fractures.


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