A vascular closure device. In each embodiment, the device includes at least one relatively non-deformable surface member and a conformable and distensible member. Typically the conformable member is implemented as a balloon structure that is inflated with a liquid or gaseous medium. This inflation fluid increases the fluid pressure in the balloon which counteracts the fluid pressure of the punctured vessel. The resulting forces on the balloon are opposed by tissue structures that transfer the load to the surrounding subcutaneous tissue structures. The device may be constructed of bioabsorbable or non-bioabsorbable materials. Additionally, the device may be coated with agents to provide a secondary therapy for enhancement of clotting or prevention of infections. These agents may also elute from the distensible conformal member.