Vascular closure device with push/pull compaction system and methods

A tissue puncture closure device includes an anchor, a suture connected to the anchor at a distal end of the suture, a sealing plug positioned proximal of the anchor, and a compaction assembly. The compaction assembly includes a compaction tube having a distal end and a proximal end, and a pivot arm having first and second ends and being rotatable about a pivot axis. The proximal end of the compaction tube is connected to the first end of the pivot arm and a proximal end of the suture is connected to the second end of the pivot arm. The compaction assembly also includes a release member operable to release the pivot arm to rotate between a first position wherein the compaction tube is withdrawn, and a second position wherein tension is applied in the suture and the compaction tube is advanced to compact the sealing plug.