A handle assembly includes a drive wire coupled to an expandable end effector, the wire having a diameter of no more than 3 French and a handle cannula receiving the wire therethrough, rotation of the handle cannula transferring torque to rotate the wire. The assembly also includes a shaft receiving the handle cannula, rotation of the shaft transferring torque to rotate the handle cannula. The assembly further includes an actuation assembly receiving the shaft, the actuation assembly coupled to a sheath sized to receive the wire and end effector therethrough, the actuation assembly moveable between a proximal configuration in which the sheath is moved proximally to expand the end effector and a distal configuration in which the sheath is moved distally to retract the end effector, the actuation assembly including a rotation mechanism transferring torque to the shaft to rotate the shaft.