1. Dr. Tejas Patel Apex Heart Institute Ahmedabad India tejaspatel@tcvsgroup.org FIRST INTERNATIONAL MULTICENTRIC REGISTRY TO KNOW THE REAL WORLD INCIDENCE OF RADIAL ARTERY SPASM DURING TRANSRADIAL APPROACH (RAS REGISTRY) Dr. Alejandro Goldsmit Sanatorio Guemes Buenos Aires Argentina ale.goldsmit@gmail.com

2. INSTRUCTION Dear Dr. Dr Tejas Patel and I want to conduct a research on the radial artery spasm (RAS) during transradial diagnostics & interventions. According to different studies, the incidence varies between 2 to 20 per cent. However, most of the studies have been done several years ago and there is a great deal of sophistication in the hardware including introducer sheaths, wires and catheters. Hence, it is important to evaluate RAS in contemporary TR practice. Different centers have different “cocktail” protocols to counter RAS. It is important to have a consensus on this issue, therefore we want to carry out an international registry to understand the real world incidence of RAS and the factors affecting it. In order to conduct this study, we invite some important institutions of South America, North America, Europe and Asia, devoted to TRI to provide us with the data we need to complete this study. Each institution will receive an excel file by email to make it more friendly, and it should be completed in 1 or 2 months, until it has sufficient statistical precision. Once the excel file is completed, it should be sent to the coordinator for data analysis. If this study is accepted for publication and / or oral presentation, names of all principal investigators and institutions will be mentioned as authors. All the information will be available for those investigators who want to conduct a new sub- study. This registry is carried out for purely academic purpose and does not have any economical benefit. Please confirm your participation on email to ale.goldsmit@gmail.com if you wish to be part of “ First international multicentric registry to know the real world incidence of Radial Artery Spasm during transradial approach (RAS Registry)” Please include: A- Principal Investigator name B- Institution Name C- Email address If you have any questions please feel free to contact Dr. Tejas Patel tejaspatel@tcvsgroup.org or Dr. Alejandro Goldsmit ale.goldsmit@gmail.com Best Regards Dear Dr. Dr Tejas Patel and I want to conduct a research on the radial artery spasm (RAS) during transradial diagnostics & interventions. According to different studies, the incidence varies between 2 to 20 per cent. However, most of the studies have been done several years ago and there is a great deal of sophistication in the hardware including introducer sheaths, wires and catheters. Hence, it is important to evaluate RAS in contemporary TR practice. Different centers have different “cocktail” protocols to counter RAS. It is important to have a consensus on this issue, therefore we want to carry out an international registry to understand the real world incidence of RAS and the factors affecting it. In order to conduct this study, we invite some important institutions of South America, North America, Europe and Asia, devoted to TRI to provide us with the data we need to complete this study. Each institution will receive an excel file by email to make it more friendly, and it should be completed in 1 or 2 months, until it has sufficient statistical precision. Once the excel file is completed, it should be sent to the coordinator for data analysis. If this study is accepted for publication and / or oral presentation, names of all principal investigators and institutions will be mentioned as authors. All the information will be available for those investigators who want to conduct a new sub- study. This registry is carried out for purely academic purpose and does not have any economical benefit. Please confirm your participation on email to ale.goldsmit@gmail.com if you wish to be part of “ First international multicentric registry to know the real world incidence of Radial Artery Spasm during transradial approach (RAS Registry)” Please include: A- Principal Investigator name B- Institution Name C- Email address If you have any questions please feel free to contact Dr. Tejas Patel tejaspatel@tcvsgroup.org or Dr. Alejandro Goldsmit ale.goldsmit@gmail.com Best Regards You received a letter invitation by email

3. IF YOU WANT TO BE PART OF THIS REGISTRY PLEASE CONFIRM BY EMAIL ale.goldsmit@gmail.com

4. YOU WILL RECIVE BY EMAIL AND EXCEL FILE

5. PLEASE INSTALL EXCEL FILE IN YOUR COMPUTER

6. REMEMBER CLINICAL SPASM DEFINITION Definitions Clinical Spasm * No spasm (Grade-0) : Patient did not experience any pain or discomfort during and immediately after the procedure. * Mild spasm(Grade-1) : Minimal local pain and discomfort during catheter movement and/or immediate post procedure period. * Moderate spasm(Grade-2) : Significant local pain and discomfort during catheter movement and/or immediate post procedure period. However, movement was possible to complete the procedure. * Severe spasm(Grade-3) : Severe local pain and discomfort during catheter movement compelling the operator to stop the procedure and cross-over to the other route. * Very severe spasm(Grade-4): Severe local pain and discomfort associated with catheter trapping.

7. HOW TO COMPLETE ? Institution Name Number Procedure of Angio Who carries out the procedure * Less experienced (experience of < 100 procedures) : * Medium level experienced (experience of 100 to 500 procedures) : * Experienced operator (> 500 procedures * Less experienced (experience of < 100 procedures) : * Medium level experienced (experience of 100 to 500 procedures) : * Experienced operator (> 500 procedures

8. The patient has previous angio (radial, femoral etc?) More than one? Don’t leave blank space

10. Which access does the patient prefer, compare it with the previous one in case there was any ? Red point means definition

12. Pre defined option If not accepted, please press “ESC” and choose again Free fill option

13. Send to ale.goldsmit@gmail.com

15. ale.goldsmit@gmail.com tejaspatel@tcvsgroup.org