Inside Medicine - The Vascular Surgeon

'I love my job and the contact I have with the patients'

In a series focusing on medical specialisms Mr Chris Imray talks about vascular surgery.

This is the branch of surgery that looks at arteries and veins.

Mr Chris Imray's CV

WHAT IS YOUR JOB?

I am a consultant vascular and renal transplant surgeon.

I work at University Hospitals Coventry and Warwickshire NHS Trust (UHCW), at Warwick Medical School and in the private sector at the BMI Meriden Hospital and the Nuffield Hospital in Leamington Spa.

I suppose the simplest way to view my job is as a plumber of human blood vessels - I deal with diseases and problems and access to the arteries and veins.

WHAT IS THE MOST COMMON CONDITION?

Varicose veins and abnormally wide or narrow arteries are the most common routine conditions, and major trauma can result in any number of life or limb threatening injuries to blood vessels which requires urgent correction.

WHAT IS THE MOST COMMON PROCEDURE?

Vascular surgery covers both arterial and venous (vein) surgery.

The most common arterial procedure I undertake is a procedure called a carotid endarterectomy.

This operation is undertaken to prevent patients having a stroke and involves clearing out the major artery to the brain.

Seeing the first beads of urine being produced by a newly-transplanted kidney still gives me an immediate buzz Mr Chris Imray

I usually do the operation under local anaesthesia talking to the patient as we proceed.

Other common procedures include operations on abnormally wide arteries (abdominal aortic aneurysms), and abnormally narrow arteries using either standard open surgery or minimally invasive techniques.

Renal transplantation involves both arterial and venous surgery, and in the last few years I have become involved in the UCHW living related kidney transplant programme.

This involves a team of surgeons removing a kidney from a healthy relative and then 'plumbing it in' to the recipient with renal failure.

Vein surgery for both symptomatic and cosmetic veins using conventional open surgery and newer minimally invasive techniques accounts for most of my 'day case' work.

WHAT IS THE HARDEST THING ABOUT YOUR JOB?

The most frustrating side of modern medicine is the increasing bureaucracy that seems unavoidable.

WHAT IS YOUR MOST SATISFYING CASE?

Successfully treating a life threatening condition such as a major trauma case or a leaking aneurysm is hugely satisfying.

Seeing the first beads of urine being produced as a newly transplanted kidney still gives me an immediate buzz.

WHY DID YOU CHOOSE THIS SPECIALTY?

I wanted to be a surgeon from my early days at medical school and vascular surgery seemed to be the most challenging of the sub-specialities.

There is an immediacy and unforgiving side to this branch of surgery that continues to challenge me - sometimes on a daily basis.

IF YOU HAD YOUR TIME AGAIN WOULD YOU CHANGE YOUR SPECIALTY?

No. I love my job and the contact I have with the patients and still cannot quite believe I get paid a good salary to do what I love.

HOW DO YOU SEE THE ROLE DEVELOPING IN THE FUTURE?

We are already seeing a major increase in the use of minimally invasive techniques.

Successfully treating a life threatening condition such as a major trauma case or a leaking aneurysm is hugely satisfying Chris Imray

It is now possible to repair major swellings in the aorta (abdominal aortic aneurysms) using wires inserted via the groin.

Patients who used to be in hospital for up to two weeks are now able to be sent home at 3-4 days.

The future is likely to result in still closer integration to the open and endovascular techniques.

CV - Mr Chris Imray

1983: Qualified from Charing Cross Hospital Medical School, Imperial College, University of London

1986: Fellow of the Royal College of Surgeons

1995: Appointed as a consultant surgeon

2005: Awarded a PhD for works in cerebral perfusion, diploma in mountain medicine, trained as renal transplant surgeon

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