A clot removal device (2000) for removing clot from a body vessel comprises an expandable structure and an elongate member. The expandable structure has a constrained delivery configuration, an expanded clot engaging deployed configuration, and an at least partially constrained clot pinching configuration. At least a portion of the expandable structure is configured to engage clot in the expanded deployed configuration and to pinch clot on movement from the deployed configuration to the clot capture configuration. The expandable structure may comprise a main body portion (2002) and a clot pinching structure (2001) and wherein a diameter of the clot pinching structure (2001) is less than a diameter of the main body portion (2002). The clot pinching structure in some cases is substantially tubular and may be of spiral form.
