This invention is a pull push device (10) for removing a clot. The device (10) includes an elongate tubular member (12) having a suction port (14) and an irrigation or fluid pressurization port (18) respectively connectable to a vacuum source (22) and a pressurized fluid reservoir. The tubular member also has a clot intake port (16) positionable through a patient's skin inside a clogged vascular vessel. The vacuum source (22) enables clot suction into the clot intake port (16) for severing while liquid pressure supplies fluid for clot ejection and device clearance. A single piece rotating or reciprocating cutter (28) and intake closure component (24) is mounted inside the tubular member for closing the clot intake port upon each small vacuum assisted severing of clot mass by the cutting element. By simultaneously severing the clot, and closing the intake port (16) by the closure component (24) the device automatically converts from a suction to a pressure mode, thus ejecting any clot through the suction port (14).