A method of closing a puncture in a blood vessel wall, including:
positioning a suture placement device in a tissue tract and into a
puncture in the blood vessel wall, the placement device having a length
of suture with a first end, a second end and a bight between the first
and second ends with the bight being prearranged on the device to define
a pre-tied knot when the first end of the suture passes through the
bight; advancing the first end of the length of suture in a distal
direction from the device through a first penetration in the blood vessel
wall adjacent to the puncture; guiding the suture length from the first
penetration across a proximal side of the puncture to a second
penetration adjacent to the puncture opposite the first penetration; and
advancing the suture length in a proximal direction through the second
penetration, through the device, and through the bight so that the two
ends of the suture length are accessible external to the tissue tract for
securing the suture across the puncture to close the puncture.