Methods for marking the location of and/or providing for an access point on a tissue wall include navigating an extended working channel (EWC) to an access point and piercing a tissue wall by piercing tool at the access point to create an opening through which the EWC may pass. The opening allows for the deployment of one or more of a diagnostic, imaging, or therapeutic modality from the EWC. Following removal of the one or more diagnostic, imaging, or therapeutic modality, a coagulant may be deposited to permit the opening to close. The location of the piercing is marked to easily identify the location at which the tissue wall was pierced for subsequent procedures.
