A key Kidney Disease Outcomes Quality Initiative (KDOQI) 2019 Vascular Access Guidelines target is to have ≤3 percutaneous or surgical interventions per year to maintain arteriovenous fistula (AVF) patency. We hypothesized first, that the number of interventions to maintain long-term AVF patency conducted in a rigorous clinical trial could be adequately documented and compared against KDOQI targets, and second, that the use of drug-coated balloons (DCB) could reduce the rate of thrombosis and interventions to maintain AVF patency more than standard uncoated balloon angioplasty (PTA).