Patent Description:
The World Health Organization estimates that <NUM>,<NUM>,<NUM> blood clots occur annually. Clots may develop and block vessels locally without being released in the form of an embolus-this mechanism is common in the formation of coronary blockages. Acute obstructions may include blood clots, misplaced devices, migrated devices, large emboli, and the like. Thromboembolism occurs when part or all of a thrombus breaks away from the blood vessel wall. This clot is then carried in the direction of blood flow. Clots can include a range of morphologies and consistencies. Long strands of softer clot material may tend to lodge at bifurcations or trifurcations, resulting in multiple vessels being simultaneously occluded over significant lengths.

Of the <NUM>,<NUM>,<NUM> clots that occur annually, one-third of patients die, and another one-third are disabled. Currently, a number of mechanical recanalization devices are in clinical use. First generation devices included the Merci Retriever device. Newer devices based on stent-like technology, referred to as "stentrievers" or "stent-retrievers", are currently displacing these first generation thrombectomy devices for recanalization in acute ischemic stroke.

There are significant challenges associated with designing clot removal devices that can deliver high levels of performance. There are also a number of access challenges that make it difficult to deliver devices. For example, the vasculature in the area in which the clot may be lodged is often fragile and delicate and neurovascular vessels are more fragile than similarly sized vessels in other parts of the body and are in a soft tissue bed. Excessive tensile forces applied on these vessels could result in perforations and hemorrhage. Pulmonary vessels are larger than those of the cerebral vasculature, but are also delicate in nature, particularly those more distal vessels.

Stent-like clot retriever devices are being increasingly used to remove clots from cerebral vessels of acute stroke patients, but such devices are not without disadvantages. A stent-like clot retriever often relies on its outward radial force to grip the clot. If the radial force is too low, the device will lose its grip on the clot. If the radial force is too high, the device may damage the vessel wall and may require too much force to withdraw. Such devices that have sufficient radial force to deal with all clot types may therefore cause vessel trauma and serious patient injury, and retrievers that have appropriate radial force to remain atraumatic may not be able to effectively handle all clot types. In this respect, retriever devices may differ in size, shape, and physical properties, such as radial force, as discussed above, ease of deployment, friction, radiopacity, and interaction with vessel wall. See, <NPL>; and <NPL>. Some designs have also been based on in-vitro stroke models that incorporate realistic clot analogs derived from animal blood that represent the wide range of human clots retrieved from stroke patients. See, <NPL> (<NUM>).

Though success rates are high when utilizing mechanical thrombectomy, there are still a proportion of patients for which adequate reperfusion cannot be achieved, certainly, in part, due to the clot not being retrieved. Cell orientation is a major influencing factor in forming a successful pinch with a microcatheter and stentriever. Certain solutions of this disclosure address these and other issues of the art.

<CIT> provides an obstruction removal device having a retrieval component used to engage an obstruction within the vasculature and a sheath component that is capable of inverting to fold over the obstruction and the retrieval component. The sheath component helps contain the obstruction and minimizes trauma to the blood vessel during the removal process.

<CIT> provides an obstruction removal device having one or more engaging members which can engage portions of the clot. The one or more engaging members have a collapsed, delivery state, and an expanded, deployed state.

The invention provides a clot removal device and method for manufacturing such a device according to claims <NUM> and <NUM>. Embodiments are provided by the dependent claims. It is an object of the present designs to provide devices and methods to meet the above-stated needs. The designs can be for a clot retrieval device capable of removing a clot from utilizing rotational pinching cells.

In some examples, there is provided a clot removal device for removing a clot from a body vessel, the clot removal device including: an elongated member sized to traverse vasculature and having a proximal end and a distal end, the elongated member comprising a longitudinal axis; and an engagement structure connected to the distal end of the elongated member, the engagement structure comprising a plurality of pinching cells connected to each other.

In some examples, the plurality of pinching cells are configured to engage the clot in an expanded deployed configuration and to pinch the clot upon actuation to a clot pinching configuration.

In some examples, a first pinching cell of the plurality of pinching cells is connected to a second pinching cell of the plurality of pinching cells such that the second pinching cell is rotatable respective the first pinching cell substantially about the longitudinal axis.

In some examples, the engagement structure is non-tubular.

In some examples, at least one of the plurality of pinching cells includes a double pinching cell.

In some examples, the second pinching cell is fully rotatable respective to the first pinching cell.

In some examples, the second pinching cell is rotatable respective the first pinching cell across an angle of about <NUM> degrees.

In some examples, a connection of the first pinching cell to the second pinching cell biases a rotational offset between the first pinching cell the first and second pinching cells.

In some examples, the biased rotational offset between the first and second pinching cells is between about <NUM> to about <NUM> degrees.

In some examples, the first pinching cell comprises a collar, and the second pinching cell comprises a mating connector configured to rotatably connect with the collar.

In some examples, the mating connector comprises collapsible fingers for insertion into the collar.

In some examples, the plurality of pinching cells comprise alternating collar pinching cells and joiner pinching cells, the collar pinching cells comprising collars on a first end and a second end of the collar pinching cells, and the joiner pinching cells comprising mating connectors configured to rotatably connect with the collars on a first end and a second end of the joiner pinching cells.

In some examples, each of the plurality of pinching cells comprises a mating connector on a first end and a collar on a second end, the mating connector being configured to rotatably connect with the collar.

In some examples, a third pinching cell of the plurality of pinching cells is connected to the second pinching cell such that the third pinching cell is rotatable respective to the second pinching cell.

In some examples, a degree of rotation of the third pinching cell respective the second pinching cell is less than a degree of rotation of the second pinching cell respective the first pinching cell.

In some examples, a degree of rotation of the third pinching cell respective the second pinching cell is greater than a degree of rotation of the second pinching cell respective the first pinching cell.

In some examples, the first pinching cell is connected to the distal end of the elongated member such that the first pinching cell is rotatable respective to the elongated member.

In some examples, the plurality of pinching cells has three or fewer pinching cells in a chain of pinching cells.

In some examples, the plurality of pinching cells has two or fewer pinching cells in the chain of pinching cells.

In some examples, there is provided a clot removal device for removing a clot from a body vessel, the clot removal device including: an elongated member sized to traverse vasculature and having a proximal end and a distal end, the elongated member defining a longitudinal axis; and an engagement structure connected to the distal end of the elongated member, the engagement structure comprising a pinching cell configured to engage the clot in an expanded deployed configuration and to pinch the clot upon actuation to a clot pinching configuration.

In some examples, the pinching cell is connected to the elongated member such that the pinching cell is rotatable respective the elongated member substantially about the longitudinal axis.

In some examples, there is provided a method for manufacturing a clot removal device, the method including: forming a plurality of pinching cells, each of the plurality of pinching cells comprising connection means to rotatably connect to at least one other pinching cell of the plurality of pinching cells; connecting a first pinching cell of the plurality of pinching cells to an elongated member sized to traverse vasculature, the elongated member defining a longitudinal axis; and connecting a second pinching cell of the plurality of pinching cells to the first pinching cell via the respective connection means of the first pinching cell and the second pinching cell.

In some examples, there is provided a method for retrieving a clot, the method including: deploying a pinching portion of a clot retrieval device into an expanded state from a collapsed state within a blood vessel and proximate the clot, the clot retrieval device including an elongated member having a distal end, the elongated member defining a longitudinal axis; and the pinching portion located proximate the distal end and comprising a plurality of pinching cells including a first pinching cell disposed proximate the distal end, and a second pinching cell rotatably connected to the first pinching cell substantially about the longitudinal axis, the pinching portion being operable to pinch the clot when transitioning from an expanded deployed configuration to a pinching configuration.

In some examples, the method further includes: advancing a lumen of a microcatheter over the pinching portion such that at least one of the plurality of pinching cells at least partially collapses into the lumen of the microcatheter; and pinching the pinching portion in contact with the portion of the clot upon actuation to the pinching configuration until a portion of the clot is compressed between the pinching portion and the microcatheter.

While the specification concludes with claims, which particularly point out and distinctly claim the subject matter described herein, it is believed the subject matter will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which like reference numerals identify the same elements and in which:.

Although example embodiments of the disclosed technology are explained in detail herein, it is to be understood that other embodiments are contemplated. Accordingly, it is not intended that the disclosed technology be limited in its scope to the details of construction and arrangement of components set forth in the following description or illustrated in the drawings. The disclosed technology is capable of other embodiments and of being practiced or carried out in various ways.

It must also be noted that, as used in the specification and the appended claims, the singular forms "a," "an" and "the" include plural referents unless the context clearly dictates otherwise. By "comprising" or "containing" or "including" it is meant that at least the named compound, element, particle, or method step is present in the composition or article or method, but does not exclude the presence of other compounds, materials, particles, method steps, even if the other such compounds, material, particles, method steps have the same function as what is named.

In describing example embodiments, terminology were resorted to for the sake of clarity. It is intended that each term contemplates its broadest meaning as understood by those skilled in the art and includes all technical equivalents that operate in a similar manner to accomplish a similar purpose. It is also to be understood that the mention of one or more steps of a method does not preclude the presence of additional method steps or intervening method steps between those steps expressly identified. Steps of a method may be performed in a different order than those described herein without departing from the scope of the disclosed technology. Similarly, it is also to be understood that the mention of one or more components in a device or system does not preclude the presence of additional components or intervening components between those components expressly identified.

More specifically, "about" or "approximately" may refer to the range of values ±<NUM>% of the recited value, e.g., "about <NUM>%" may refer to the range of values from <NUM>% to <NUM>%.

As discussed herein, the vasculature of a "subject" or "patient" may be vasculature of a human or any animal. It should be appreciated that an animal may be a variety of any applicable type, including, but not limited thereto, mammal, veterinarian animal, livestock animal or pet type animal, etc. As an example, the animal may be a laboratory animal specifically selected to have certain characteristics similar to a human (e.g., rat, dog, pig, monkey, or the like). It should be appreciated that the subject may be any applicable human patient, for example.

As discussed herein, "operator" may include a doctor, surgeon, or any other individual or delivery instrumentation associated with delivery of a clot revascularization device to the vasculature of a subject.

As discussed herein, "thrombus" can be understood as a clot in the circulatory system that remains in a site of the vasculature hindering or otherwise obstructing flow in a blood vessel. The terms, "clot", "thrombus", "obstruction", "occlusion", "blockage", and/or the like, can be and are often used interchangeably throughout this disclosure.

Delivery of a "revascularization device" is typically accomplished via delivery of one or more catheters into the femoral artery and/or the radial artery, guided into the arteries of the brain, vascular bypass, angioplasty, and/or the like. "Revascularization devices" can include, but not be limited to, one or more stents, stentrievers, clot removal devices, clot revascularization devices, aspiration systems, one or more combinations thereof, and/or the like, each of which are often used interchangeably throughout this disclosure.

<FIG> illustrates a stentriever and microcatheter <NUM> (e.g., a clot removal device <NUM>) according to aspects of the present disclosure. Clot removal device <NUM> may include microcatheter <NUM> and a stentriever <NUM>. Microcatheter <NUM> has a proximal end <NUM> and a distal end <NUM> disposed opposite thereof. Microcatheter <NUM> includes a lumen <NUM> passing from the proximal end <NUM> to the distal end <NUM>.

Stentriever <NUM> may include an engagement structure <NUM> and an elongated member <NUM> (e.g., a structural thread <NUM>) defining a longitudinal axis L-L. The engagement structure <NUM> may include at least a first and a second pinching cell <NUM>. For example, engagement structure <NUM> may include a chain of pinching cells <NUM> connected to a distal end <NUM> of the structural thread <NUM>. In a delivery configuration, the engagement structure <NUM> may be disposed within lumen <NUM> within the microcatheter <NUM>. Once delivered, the engagement structure <NUM> may be extended from the microcatheter <NUM> (e.g., via a hand control or a pushpull mechanism). At least one of the pinching cells <NUM> may be configured to be rotationally independent, e.g., of adjacent cells <NUM> and/or the structural thread <NUM>. For example, as struts of the pinching cells <NUM> expand into clots, the pinching cell <NUM> deflects, causing rotation of the pinching cell <NUM>-formed cage to improve integration of the clot into the pinching cell <NUM>. This may lead to a greater likelihood of successful pinching of the clot by the pinching cell <NUM>.

<FIG> illustrate example pinching cells <NUM> according to aspects of the present disclosure. Referring to <FIG>, pinching cell <NUM> may have a first end <NUM>, a second end <NUM> disposed on the opposite side thereof, and a generally cylindrical capturing portion <NUM> disposed therein. The capturing portion <NUM> may include a plurality of arms 212a-212d (e.g., struts), creating a cage therebetween. The arms 212a-212d may have a substantially arced shape be configured to capture a clot within the cage. The first end <NUM> and the second end <NUM> may be configured to connect to one or more neighboring pinching cells and/or structural thread <NUM>.

Referring to <FIG>, pinching cell <NUM>' may have a first end <NUM>', a second end <NUM>' disposed on the opposite side thereof, and a generally flat capturing portion <NUM>' disposed therein. The capturing portion <NUM>' may include a plurality of arms 212a'-212c' (e.g., struts), creating a cage therebetween. The arms 212a'-212c' may have waved shape that may, in some cases, improve capture characteristics.

Referring to <FIG>, pinching cell <NUM>" may have a first end <NUM>', a second end <NUM>' disposed on the opposite side thereof, and a generally capturing portion <NUM>" disposed therein. The capturing portion <NUM>" may include a plurality of cells 212a" -212c" (e.g., struts), creating a plurality of cage spaces therebetween. The cells 212a"-212c" may each have a substantially ovular shape and be connected to the first end <NUM>' and the second end <NUM>' via arms.

<FIG> illustrate example pinching cells <NUM> according to aspects of the present disclosure. Referring to <FIG>, pinching cell <NUM> may have a first end <NUM>, a second end <NUM> disposed on the opposite side thereof, and a generally hexagonal capturing portion <NUM> disposed therein. The capturing portion <NUM> may include a plurality of arms 312a-312c (e.g., struts), creating a cage therebetween. The arms 312a-312c may have substantially straight edges configured to capture a clot within the cage.

Referring to <FIG>, pinching cell <NUM>' may have a first end <NUM>', a second end <NUM>' disposed on the opposite side thereof, and a capturing portion <NUM>' disposed therein. The capturing portion <NUM>' may include a plurality of arms 312a'-312c' (e.g., struts), creating a cage therebetween. The arms 312a'-312c' may have generally straight edges with one or more indentions, for example, formed proximate a middle portion of the capturing portion <NUM>'.

Although specific connector types have been described above with reference to <FIG>, one of ordinary skill will recognize that the pinch cells may be replaced with similar or alternative pinch cells without departing from the scope of the present disclosure.

<FIG> illustrate example pinching cell connection configurations for pinching cells <NUM> and <NUM> according to aspects of the present disclosure. Referring to <FIG>, pinching cell <NUM> may include a t-style connector <NUM> on each end (e.g., a joiner pinching cell). The t-style connector <NUM> (<FIG>) may be configured to allow approximately <NUM>-degree rotation relative to a connecting structure (e.g., a connecting pinching cell and/or thread <NUM>). The t-style connector <NUM> may have two fingers extending from a central portion. Referring to <FIG>, pinching cell <NUM>' may include a hook-style connector <NUM>' on each end (e.g., a joiner pinching cell). The hook-style connector <NUM>' (<FIG>) may be configured to allow approximately <NUM>-degree rotation relative to a connecting structure (e.g., a connecting pinching cell and/or thread <NUM>). The hook-style connector <NUM>' may have a single finger extending from a central portion. Referring to <FIG>, pinching cell <NUM>" may include a hook-style connector <NUM>" on each end (e.g., a joiner pinching cell). The ball-joint connector <NUM>" (<FIG>) may be configured to allow substantially free rotation (e.g., <NUM> degrees) relative to a connecting structure (e.g., a connecting pinching cell and/or thread <NUM>). The ball-joint connector <NUM>" may have a ball-joint formed on an end of a central portion.

Referring to <FIG>, pinching cell <NUM> may include a collar connector <NUM> (e.g., a collar) on each end (e.g., a collar pinching cell <NUM>). Collar connector <NUM> may be configured to connect to, for example, a t-style connector <NUM>, a hook-style connector <NUM>', and/or a ball-joint connector <NUM>" of a connecting structure (e.g., a connecting pinching cell and/or thread <NUM>). The collar connector <NUM> may be adaptable to allow different relative rotation based on a type of connected connector. Referring to <FIG>, pinching cell <NUM>' may include a collar connector <NUM>' on one end and a t-style connector <NUM> on the other end. The collar connector <NUM>' may be configured to connect to a mating connector of a neighboring pinch cell and/or thread <NUM>. The t-style connector <NUM>, may be configured to connect to a collar connector of a neighboring pinch cell and/or thread <NUM>. In this way, a single type of cell may be made and connected to for a chain of pinch cells. Referring to <FIG>, pinching cell <NUM>" may include a t-style connector <NUM> on one end and a ball-style connector <NUM>" on the other end (e.g., a joiner pinching cell). In this way, pinching cell <NUM>" may be configured to have different relative rotational characteristics to neighboring cells and/or threads <NUM> on the opposite side of pinching cell <NUM>".

In some cases, connections may bias certain rotational offsets between neighboring cells <NUM>. For example, in some cases, a biased rotational offset between the first and second pinching cells may be between about <NUM> to about <NUM> degrees or between about <NUM> and <NUM> degrees. Although specific connector types have been described above with reference to <FIG>, one of ordinary skill will recognize that the types of connectors may be replaced with similar or alternative connectors without departing from the scope of the present disclosure.

<FIG> illustrate example pinch cell chains <NUM> according to example embodiments. Referring to <FIG>, pinching cell chain <NUM> may have two pinch cells <NUM> relatively rotatable about connection <NUM>. Depending on the type of connection, cells <NUM> may be relatively rotatable by about <NUM> degrees, about <NUM> degrees, or about <NUM> degrees, but these are merely examples. Referring to <FIG>, pinching cell chain <NUM>' may have three pinch cells <NUM>' attached via connections <NUM>'. Depending on the type of connection, cells <NUM>' may be relatively rotatable to neighboring cells by about <NUM> degrees, about <NUM> degrees, or about <NUM> degrees, but these are merely examples. In some cases, different neighboring cells <NUM>' may have different rotational characteristics. For example, first and second cells <NUM>' may be relatively rotatable by <NUM> degrees, while second and third cells may be relatively rotatable by <NUM> degrees or be substantially rotationally fixed. IN <FIG>, neighboring cells may have a biased rotational offset, for example, between <NUM> and <NUM> degrees. Referring to <FIG>, pinching cell chain <NUM>" may have four or more pinch cells <NUM>" attached via connections <NUM>". Depending on a type of connection, cells <NUM>" may be relatively rotatable to neighboring cells by about <NUM> degrees, about <NUM> degrees, or about <NUM> degrees, but these are merely examples. In some cases, different neighboring cells <NUM>" may have different rotational characteristics.

Referring to <FIG>, pinching cell chain <NUM>‴ may have two double-celled pinch cells <NUM>'" attached via connections <NUM>‴. Depending on a type of connection, cells <NUM>‴ may be relatively rotatable to neighboring cells by about <NUM> degrees, about <NUM> degrees, or about <NUM> degrees, but these are merely examples. Referring to <FIG>, pinching cell chain <NUM>"" may have two double pinching cells <NUM>"" attached via connections <NUM>"". Within the double-cell structure <NUM>"", the individual pinching cells <NUM> may also be relatively rotatable via connections <NUM> depending on a type of connection, cells <NUM>‴ may be relatively rotatable to neighboring cells by about <NUM> degrees, about <NUM> degrees, or about <NUM> degrees, but these are merely examples. The use of double pinching cells may be considered a non-tubular engagement structure.

<FIG> and <FIG> illustrate an operation of a microcatheter <NUM> and stentriever <NUM> according to aspects of the present disclosure. Microcatheter <NUM> and stentriever <NUM> may be moved within a blood vessel <NUM> to clot <NUM>. The engagement structure <NUM> may be positioned within the microcatheter <NUM>, e.g., in a collapsed configuration. Once positioned correctly, engagement structure <NUM> may be extended from microcatheter <NUM>. The engagement structure <NUM> may interfere with clot <NUM>. The engagement structure <NUM> may then be partially retracted into microcatheter <NUM>, for example, as shown in <FIG>. Accordingly, engagement structure <NUM> may pinch clot <NUM> against microcatheter <NUM> (e.g., in a pinching configuration).

<FIG> illustrates a stentriever and microcatheter <NUM> (e.g., a clot removal device <NUM>) according to aspects of the present disclosure. Clot removal device <NUM> may include microcatheter <NUM> and a stentriever <NUM>. Stentriever <NUM> may include an engagement structure <NUM>, including a single chain of pinch cells <NUM>. The chain of pinching cells <NUM> connected to a distal end <NUM> of the structural thread <NUM>. In a delivery configuration, the engagement structure <NUM> may be disposed within microcatheter <NUM>. Once delivered, the engagement structure <NUM> may be extended from the microcatheter <NUM> (e.g., via a hand control or a pushpull mechanism). At least one of the pinching cells <NUM> may be configured to be rotationally independent, e.g., of adjacent cells <NUM> and/or the structural thread <NUM> via connections <NUM>. For example, as struts of the pinching cells <NUM> expand into clots, the pinching cell <NUM> deflects, causing rotation of the pinching cell <NUM> cage to improve integration of the clot into the pinching cell <NUM>. This may lead to a greater likelihood of successful pinching of the clot by the pinching cell <NUM> as compared to relatively fixed pinching cells.

<FIG> and <FIG> illustrate an operation of a microcatheter <NUM> and stentriever <NUM> according to aspects of the present disclosure. Microcatheter <NUM> and stentriever <NUM> may be moved within a blood vessel <NUM> to clot <NUM>. The engagement structure <NUM> may be positioned within the microcatheter <NUM>, e.g., in a collapsed configuration. Once positioned correctly, engagement structure <NUM> may be extended from microcatheter <NUM>. The engagement structure <NUM> may interfere with clot <NUM>, for example, by a cell <NUM> rotating and increasing inference therewith. The engagement structure <NUM> may then be partially retracted into microcatheter <NUM>, for example, as shown in <FIG>. Accordingly, engagement structure <NUM> may pinch clot <NUM> against microcatheter <NUM> (e.g., in a pinching configuration).

<FIG> illustrate connecting of adjacent cells according to aspects of the present disclosure. A cell with a collar connector <NUM> and a cell with a t-style connector <NUM> are provided (<FIG>). The t-style connector <NUM> is inserted into the collar connector. The fingers <NUM> of the t-style connector <NUM> deform (e.g., be collapsible fingers) and expand once the first cell and the second cell are combined (<FIG>). Thereafter, the t-style connector may have certain rotational freedom such that the first and the second cell are rotationally independent (for example, over <NUM> degrees). Although t-style and collar connectors are discussed, one of ordinary skill would recognize that various different or alternative cell connectors and connection mechanisms may be employed without departing from the scope of the present disclosure.

<FIG> is a flowchart <NUM> of producing a stentriever according to aspects of the present disclosure. The method may include forming <NUM> a plurality of pinching cells (e.g., pinching cell <NUM>). Each of the plurality of pinching cells comprising connection means to rotatably connect to at least one other pinching cell of the plurality of pinching cells. A first pinching cell of the plurality of pinching cells may be connected <NUM> to an elongated member (e.g., thread <NUM>) that is sized to traverse vasculature. Then, a second pinching cell (e.g., cell <NUM>) of the plurality of pinching cells may be connected <NUM> to the first pinching cell via the respective connection means of the first pinching cell and the second pinching cells. Additional cells <NUM> may be connected <NUM> until a chain of desired length is formed.

<FIG> is a flowchart <NUM> of a treatment incorporating an example clot removal device (e.g., combination stentriever and microcatheter <NUM> or <NUM>) according to aspects of the present disclosure. The method includes deploying a pinching portion <NUM> of a clot retrieval device into an expanded state from a collapsed state within a blood vessel <NUM>, the pinching portion including a first pinching cell, and a second pinching cell rotatably connected to the first pinching cell. The clot removal device may be a microcatheter and stentriever (e.g., <NUM> or <NUM>) and may include a microcatheter (e.g., <NUM>) and a stentriever (e.g., <NUM>). A lumen <NUM> of the microcatheter may be advanced <NUM> over the pinching portion <NUM> such that at least one of the plurality of pinching cells at least partially collapses into the lumen <NUM> of the microcatheter <NUM>.

The pinching portion <NUM> may be pinched <NUM> in contact with the portion of the clot <NUM> on movement from the deployed configuration to the pinching configuration until a portion of the clot <NUM> is compressed between the pinching portion <NUM> and the microcatheter <NUM>. The clot removal device may then be withdrawn from the blood vessel1 with the clot <NUM>.

Claim 1:
A clot removal device (<NUM>) for removing a clot (<NUM>) from a body vessel (<NUM>), the clot removal device (<NUM>) comprising:
an elongated member (<NUM>) sized to traverse vasculature and having a proximal end and a distal end, the elongated member (<NUM>) comprising a longitudinal axis; and
an engagement structure (<NUM>) connected to the distal end of the elongated member (<NUM>), the engagement structure (<NUM>) comprising a plurality of pinching cells (<NUM>) connected to each other,
the plurality of pinching cells (<NUM>) being configured to engage clot (<NUM>) in an expanded deployed configuration and to pinch the clot upon actuation to a clot pinching configuration,
a first pinching cell of the plurality of pinching cells being connected to a second pinching cell of the plurality of pinching cells such that the second pinching cell is rotatable respective the first pinching cell substantially about the longitudinal axis;
characterised in that
the first pinching cell comprises a collar (<NUM>) and the second pinching cell comprises a mating connector (<NUM>) configured to rotatably connect with the collar (<NUM>).