Catch Up with the Latest Trend in Vascular Access Intervention

Vascular access dysfunction remains a significant challenge in hemodialysis patients, primarily caused by stenosis and occlusion in arteriovenous fistulas and grafts. Recent advancements in percutaneous transluminal angioplasty have introduced innovative tools such as drug-coated balloons and stent grafts. Drug-coated balloons enhance patency by reducing neointimal hyperplasia through localized drug delivery, with superior outcomes demonstrated in randomized controlled trials. Stent grafts provide structural support and mitigates restenosis at venous anastomoses but faces challenges in maintaining long-term patency. Cutting balloons, a well-established device, offer a unique mechanism of controlled fibroelastic disruption, making them effective for resistant stenoses. This review evaluates the clinical impact of these devices, focusing on evidence from Japan, and emphasizes the importance of selecting the appropriate device based on individual lesion characteristics.