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We developed the Thrombectomy in Limb Ischemia (TILI) score, a novel angiographic classification system to systematically assess the technical efficacy of thrombectomy in ALI of embolic origin. The TILI Score was designed through consensus by a Swiss-wide research group of specialists in angiology, vascular surgery, and interventional radiology. It comprises of two components: (1)\n                    <jats:italic>lesion recanalisation<\/jats:italic>\n                    (Grades 0\u20133), and (2)\n                    <jats:italic>peripheral embolisation<\/jats:italic>\n                    (Grades a\u2013c, \u00b1p), the latter assessed only if recanalisation is Grade 2 or 3. For the pilot validation, inter-reader reproducibility, 10 expert readers were asked to grade 10 representative post-thrombectomy angiograms after standardized training. Agreement was quantify using percentage agreement, Gwet\u2019s agreement coefficient (AC2; quadratic and ordinal weights), and intra-class correlation coefficients (ICC). Nine readers completed the assessment. For the full composite scale agreement reached 93.6% (95% CI: 91.2\u201396.1), with substantial agreement reliability (Gwet\u2019s AC2\u2009=\u20090.74 and 0.72) and ICC of 0.756 (95% CI: 0.449\u20130.886). For the main recanalisation grade (0\u20133), agreement was higher: 95.1% (95% CI: 92.1\u201398.2), with almost perfect agreement reliability (AC2 of 0.875 and 0.862). The TILI Score is the first structured and reproducible tool to classify the technical success of thrombectomy in ALI in patients without preexisting occlusive disease. It demonstrated substantial to almost perfect interobserver agreement among experts and may serve as a standardized endpoint for future thrombectomy trials. Broader clinical validation is necessary to define outcome-relevant thresholds.\n                  <\/jats:p>","DOI":"10.1007\/s10554-026-03617-9","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T09:24:13Z","timestamp":1771406653000},"page":"711-720","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The thrombectomy in limb ischemia score (TILI-Score): score proposal and results of an interobserver readability survey"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7108-418X","authenticated-orcid":false,"given":"Aleksandra","family":"Tuleja","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Zbinden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludovica","family":"Ettorre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria-Antonela","family":"Ruffino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greicy","family":"Heymann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9line","family":"Deslarzes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Sebastian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna-Leonie","family":"Menges","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Maike","family":"Bernhard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrice No\u00ebl","family":"Helfenstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Bosiers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Schindewolf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"issue":"2","key":"3617_CR1","doi-asserted-by":"publisher","first-page":"654","DOI":"10.1016\/j.jvs.2019.05.031","volume":"71","author":"EB van der Veenstra","year":"2020","unstructured":"Veenstra EB, van der Laan MJ, Zeebregts CJ, de Heide EJ, Kater M, Bokkers RPH (Feb 2020) A systematic review and meta-analysis of endovascular and surgical revascularization techniques in acute limb ischemia, (in eng). 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