For decades, clinical research in hemodialysis access was characterized by a paucity of well-designed and well-executed clinical trials, hindering development of evidence-based practice in this area. Thus, it is very refreshing to see more modern studies generating level 1 evidence for vascular access management. Drug-coated balloons (DCBs) for the prevention of restenosis in hemodialysis fistulas have now undergone rigorous evaluation, arguably more than any other arteriovenous access intervention apart from stent grafts for venous stenosis.