CIRSE Fellowship report: Dr. Paula Escarcena

My name is Paula Escarcena, and I am a junior interventional radiology consultant at the Department of Radiology in Hospital Clínic de Barcelona, Spain. I completed my residency in diagnostic and interventional radiology at Hospital Parc Taulí (Sabadell, Barcelona) in 2021 after which I completed a one-year fellowship in interventional radiology accredited by SERVEI (Sociedad Española de Radiologia Vascular e Intervencionista) at the same hospital.

Throughout my training, I have always been interested in seeing how interventional radiology is practiced in different places. I’ve had the opportunity to spend time training outside my home city, including rotations in Portugal and Brazil. I truly enjoy discovering how teams work and organize themselves in other institutions, as I find it enriching both professionally and personally.

Over the past few years, I have developed a strong interest in venous pathology, an area I am particularly passionate about. In my hospital back home, the multidisciplinary team focused on venous thromboembolic disease is still relatively new, and we are continuously gaining experience and refining our approach to diagnosing, treating, and following up patients with these conditions.

For these reasons, I decided to apply to the CIRSE fellowship grant programme. I was especially interested in spending time with Prof. Gerard O’Sullivan and his team to deepen my clinical and technical knowledge in venous disease and to observe how a well-established service functions, while also embracing the added challenge of working daily using a language other than my own.

The first thing I want to highlight was the welcoming and supportive environment I found in Galway. From day one, Prof. O’Sullivan, Dr. O’Brien, Dr. Mullins, Dr. Sheppard and Dr Davidson, together with the entire team – including nurses, radiographers, and support staff – made me feel comfortable and supported. They were always willing to help, answer questions, and guide me; especially during the first weeks when navigating a new hospital system in English (with the added challenge of an Irish accent!) was a bit daunting.

Regarding venous pathology, although I was not fortunate enough to witness a high volume of acute or chronic thrombosis cases during my month in Galway, I was still able to participate in several interesting procedures. These included a case of chronic iliac vein thrombosis, an acute upper limb thrombosis involving the upper limb veins in a patient with cancer, as well as multiple pelvic vein embolizations. In addition to the procedures performed during my stay, the team generously shared with me a large number of past venous cases. We reviewed them in detail, discussing clinical indications, technical approaches, materials used, and patient follow-up. His openness in granting me access to such a broad and diverse case library was incredibly valuable and I consider it one of the highlights of my learning experience.

Moreover, one of the most memorable moments of this fellowship was the chance I had to return a few months later and join the team during their participation in the venous pathology sessions at the LINC. I had the privilege of assisting in several high-level cases, including a full iliocaval venous reconstruction, a complex IVC filter retrieval after several years in place, a pelvic vein embolization, and a case of May-Thurner syndrome treatment. It was a truly unforgettable day – not only because of the complexity and diversity of the cases, but also because of the exceptional teamwork demonstrated by everyone involved. From healthcare assistants and radiographers to nursing staff and anaesthesiologists, the level of coordination and mutual support ensured that the workflow was smooth and efficient, allowing all cases to be completed on time and to the highest standard. The perfect ending to that intense and rewarding day was the celebratory dinner we all shared as a team – a gesture that reflected the camaraderie and commitment that define this outstanding group of professionals.

Besides venous pathology, during my rotation I was exposed to a wide range of procedures that I do not normally see or perform in my daily practice. I had the chance to observe and assist in lung, abdominal, retroperitoneal, and bone lesion punctures, biopsies, and drainages, guided by ultrasound, CT, and fluoroscopy. These are typically not carried out by our interventional radiology team back home, so being involved in these cases allowed me to significantly broaden my technical knowledge and gain confidence in performing these types of interventions.

In addition to the interventional procedures, I also took part in the weekly multidisciplinary meetings with the vascular surgery team, where complex cases were discussed. I also participated in outpatient clinics and varicose vein ultrasound assessments, which allowed me to gain a more comprehensive view of venous disease management beyond the angiosuite.

One of the most valuable aspects of this experience was the mentorship I received from Prof. O’Sullivan. Beyond the technical skills learned in the angio suite, I greatly appreciated our many conversations outside the procedure room. He shared insightful clinical advice, strategies for engaging with other specialties, and emphasized the importance of interventional radiology as a truly clinical specialty. His guidance on building trust with referring clinicians, increasing visibility, and growing as a professional was truly inspiring. These discussions were, without a doubt, one of the most meaningful parts of my fellowship and will help shape both my professional development and personal growth moving forward.

Choosing to go to Galway was an excellent decision, and I would strongly encourage other trainees to take full advantage of the CIRSE Fellowship Programme. It is a fantastic way to learn from leading centres abroad, gain new perspectives on interventional radiology practice, and grow in an international and collaborative environment.