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Patients with primary arteriovenous fistula failure underwent oversized balloon angioplasty with high-pressure balloons alone or with high-pressure balloons\u2009+\u2009drug-coated balloons. Vascular access primary and secondary patency rates were evaluated at 3, 6, and 12\u00a0months in 198 patients. The safety endpoint was the incidence of procedure-related complications. Exploratory analyses included the impact of demographic and clinical variables on primary patency rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Technical success was achieved in 99% of patients (196\/198). At 12\u00a0months, vascular access primary patency was 57.8% for high-pressure balloons\u2009+\u2009drug-coated balloons vs. 41.3% for high-pressure balloons alone (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011). Twelve-month vascular access secondary patency rates were similar between groups (88.5% for high-pressure balloons\u2009+\u2009drug-coated balloons vs. 87.0% for high-pressure balloons alone, p\u2009=\u20090.69). Cox regression analysis identified oversized balloon angioplasty with drug-coated balloons and male sex as protective factors, reducing the 12\u00a0month risk of primary patency loss. In contrast, brachiocephalic arteriovenous fistulas and initial thrombosis were associated with an increased risk of patency loss.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Oversized balloon angioplasty with drug-coated balloons improved primary patency compared to high-pressure balloons alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00270-025-04336-9","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T15:28:28Z","timestamp":1769786908000},"page":"1165-1174","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of Clinical Effectiveness of Drug-Coated Balloons versus Percutaneous Transluminal Angioplasty in Arteriovenous Fistulae Maturation Failure: A Multicenter Prospective Study"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9012-9649","authenticated-orcid":false,"given":"Leonardo","family":"Harduin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Cortizo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rcio Gomes","family":"Filippo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiago Almeida","family":"Barroso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Bandeira","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata Silveira","family":"Mello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Alexandre Rosa","family":"Gama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda Kaori Ishiy","family":"Ozima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brunno Ribeiro","family":"Vieira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Eduardo Ocke","family":"Reis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge Paulo","family":"Strogoff-de-Matos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"4336_CR1","doi-asserted-by":"publisher","first-page":"2164","DOI":"10.1001\/jama.299.18.2164","volume":"299","author":"LM Dember","year":"2008","unstructured":"Dember LM, Beck GJ, Allon M, Delmez JA, Dixon BS, Greenberg A, et al. 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T.A.B., M.G.F., and L.C.A. report receiving research grants from Merit Medical Systems, Scitech Medical\u00a9, and Bard BD, as well as consulting and lecture fees from Medtronic, Bard BD, Merit Medical Systems, Scitech Medical, and Gore. J.P.S.M. received consultancy fees from Fresenius Medical Care Brazil.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The research ethics committee at the Universidade Federal Fluminense, Rio de Janeiro, Brazil, approved the study under ethical appreciation number 55923222.1.0000.5243.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Consent for publication was obtained for every individual person\u2019s data included in the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}