Systems and methods for establishing hemostasis relative to a puncture in a lumen wall. A closure device includes a proximal portion and a distal portion. The proximal portion or distal portion rotates during deployment to either close a puncture or plug a puncture to establish hemostasis. A method includes positioning a closure device in a deployment device, positioning the closure device in the tissue tract, and actuating the deployment device to establish relative rotation between the distal portion and the proximal portion of the closure device.
