Dr. Gary Roubin Accepts the Career Achievement Award

by Lauren LeBano

On Tuesday morning, Dr. Gary S. Roubin will receive the Career Achievement Award for his groundbreaking contributions to the vascular field, including the development of the first balloon-expandable coronary stent. Dr. Roubin has been practicing cardiovascular interventions for more than 30 years, and in that time, he has promoted collaboration among the various specialties and pioneered techniques that have revolutionized patient care.

Early in his career, Dr. Roubin developed a passion for percutaneous techniques and the broader value of intervention not just in the heart, but in the peripheral vessels. He wanted to figure out how to avoid the complications and trauma that result from more invasive surgical procedures, and the first stent was a vital step in that direction.

“At the time, the thought of putting metal in a beating, twisting coronary artery was considered pretty outrageous,” Dr. Roubin says. “But it was one of those gratifying events that busy innovative clinicians have when an intervention definitively changes the course for the patient.” Before the stent procedure, his patient had a dissected artery and was imminently facing a heart attack and complicated emergency bypass surgery. “Then we put the stent in, and it stabilized everything. It was clearly something that made a difference, a parachute moment that stopped the freefalling to the ground.”

The new technique allowed coronary intervention to prevail and expand to what it has become today. And stenting allowed peripheral and carotid intervention to develop to another level with the security that came from the scaffold provided by the stent. Dr. Roubin, always seeking additional opportunities to improve patient care, was also responsible for the first carotid bifurcation stenting. “It’s taken 20 years of rigorous scientific validation to establish these techniques, and I’m proud that we’ve done it,” he says, citing the importance of collaboration with colleagues throughout the process.

Recently, Dr. Roubin was the principal investigator for intervention in the CREST trial and now the CREST-2 trial. The CREST trial was the validation that carotid stenting was as safe and efficacious as endarterectomy, and the ongoing CREST-2 is comparing stenting and endarterectomy to standard medical therapy. Dr. Roubin has also been fascinated with the opportunity to find safer and more efficacious ways to gain access to the femoral artery for PEVAR and TAVR, and he recently finished a clinical trial on the MANTA device that will help facilitate large-bore vascular closure.

Proper research through clinical trials is paramount to the advancement of the field, and Dr. Roubin strives to communicate the importance of rigor at every opportunity. “The main message of many of my talks is that when we innovate, we must scientifically validate in a rigorous way. When we come up with new techniques that we believe are beneficial, we must conduct good clinical trials. We learn much more that way than we do from anecdotal experience,” he says.

In addition to his research work, Dr. Roubin continues to practice as a clinician. As he looks back on his career, the contrast between patient outcomes of decades ago versus present-day is substantial. “Our ability now to save the heart muscle from damage by quickly placing in a stent is one of the most gratifying things that I’ve accomplished,” he says. Dr. Roubin adds that recent advances in stroke intervention with the removal of clots going to the brain have also been striking to witness, as they stem from the fundamental techniques he pioneered at the beginning of the discipline.

The success and dissemination of the techniques Dr. Roubin developed came about as the result of interdisciplinary collaboration, an approach that defines his career. For decades, he focused on bringing physicians together for the benefit of patients, and he was one of the first cardiology-trained individuals to become a member of the interventional radiology society. “I recognized early on that it was collaboration, not competition, among interventional radiologists, cardiologists, and vascular surgeons that produced the best results for patients,” he says.

His hope for the future is that collaboration and innovation continues. “I’ve learned so much from my interventional radiology and vascular surgery colleagues that I just want to continue this professional interaction,” he says. “It’s through this type of collaboration that we have made the advances that have occurred over the last 30 years.”