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