A clot removal device for removing clot from a body vessel includes an expandable structure having a constrained delivery configuration, an expanded clot engaging deployed configuration, and an at least partially constrained clot pinching configuration, the expandable structure including a proximal section comprising a plurality of struts with opening angles; a mid-section distal of the proximal section and comprising a plurality of struts with opening angles and cells larger than cells of the proximal section, the mid-section being configured to expand a larger radial extent in the deployed configuration than the proximal section to provide clot grip and retention during retraction of the clot; wherein the proximal section is configured to pinch the clot from the body vessel when partially resheathed by a microcatheter.