As of 2017, two randomized clinical trials are being conducted to better understand the optimal revascularization technique for severe PAD and critical limb ischemia (CLI), the BEST-CLI (Best Endovascular Versus Best Surgical Therapy for Patients With Critical Limb Ischemia) Trial, and the BASIL-2 (Bypass Versus Angioplasty in Severe Ischaemia of the Leg – 2 )Trial.In 2011, pCMV-vegf165 was registered in Russia as the first-in-class gene therapy drug for treatment of PAD, including the advanced stage of critical limb ischemia. References
External links
"Peripheral Arterial Disease" at the National Heart, Lung and Blood Institute
Peripheral Arterial Disease (P.A.D.) at the American College of Foot and Ankle Surgeons
Gerhard-Herman, Marie D.; Gornik, Heather L.; Barrett, Coletta; Barshes, Neal R.; Corriere, Matthew A.;  et al. (November 13, 2016). "2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary". Circulation. 135 (12): e686–e725. doi:10.1161/CIR.0000000000000470. PMC 5479414. PMID 27840332.
Punishment
Some parents punished children with a dose of castor oil. Physicians recommended against the practice because they did not want medicines associated with punishment.A heavy dose of castor oil could be used as a humiliating punishment for adults. Colonial officials used it in the British Raj (India) to deal with recalcitrant servants. Belgian military officials prescribed heavy doses of castor oil in Belgian Congo as a punishment for being too sick to work.The most famous use as punishment came in Fascist Italy under Benito Mussolini. It was a favorite tool used by the Blackshirts to intimidate and humiliate their opponents. Political dissidents were force-fed large quantities of castor oil by Fascist squads. This technique was said to have been originated by Gabriele DAnnunzio or Italo Balbo. Victims of this treatment did sometimes die, as the dehydrating effects of the oil-induced diarrhea often complicated their recovery from the nightstick beatings they also received along with the castor oil; however, even those victims who survived had to bear the humiliation of the laxative effects resulting from excessive consumption of the oil. Safety
The castor seed contains ricin, a toxic lectin. Heating during the oil extraction process denatures and deactivates the lectin. Harvesting castor beans, though, may not be without risk. The International Castor Oil Association FAQ document states that castor beans contain an allergenic compound called CB1A. This chemical is described as being virtually nontoxic, but has the capacity to affect people with hypersensitivity. The allergen may be neutralized by treatment with a variety of alkaline agents.