Hemodialysis vascular access dysfunction remains a major cause of morbidity and repeated interventions. Stenosis related to neointimal hyperplasia and altered hemodynamics leads to access flow limitation and thrombosis, particularly in AVFs. While percutaneous transluminal angioplasty is the standard first-line treatment, durability is often limited, resulting in frequent reinterventions. Drug-coated balloons, most commonly paclitaxel-based, have been introduced to inhibit restenosis and have demonstrated improved target lesion patency compared with conventional balloon angioplasty in several randomized trials, though outcomes vary by lesion location and study design. This narrative review summarizes the current evidence for drug-coated balloon angioplasty in dysfunctional arteriovenous access, discusses key trial endpoints, reviews safety and practical considerations, and highlights ongoing controversies and future directions.

<b>Purpose</b><br/>This study aimed to evaluate the clinical efficacy and patency of stents placed for symptomatic iliac vein or IVC obstruction caused by malignant tumors. Material and Methods: A total of 34 consecutive patients with malignant iliac vein or IVC obstruction underwent stent placement. We reviewed their electronic medical records, pre- and post-procedural CT scans, and angiograms retrospectively, and evaluated technical success, clinical success, and patient-based and vessel-based reocclusion rates confirmed by follow-up cross-sectional images. The reocclusion rate difference between IVC and iliac stents was also assessed. <br/><b>Results</b><br/>All patients complained of leg and/or trunk edema. The stents were placed in the following locations: IVC (n = 9); iliac veins (n = 19); and both IVC and iliac veins (n = 6). Technical success rate was 100% and the clinical success rate was 87.5% during hospitalization. Cross-sectional area of the affected thigh was significantly decreased after stent placement (mean 11.7%, p = 0.003). The median follow-up period was 65 days (Q1–Q3, 28.5–227.3; IQR, 198.8). The patient-based reocclusion rate was 42.8%. The vessel-based reocclusion rates for IVC (12.5%) tended to be lower than those of iliac veins (45%), though the difference was not statistically significant (p = 0.194). <br/><b>Conclusion</b><br/>Stent insertion for iliac vein or IVC obstruction secondary to malignancy is technically feasible and can help to improve patients’ symptoms. IVC stents tend to achieve a higher rate of patency than iliac vein stents.