Please select the eligibility criteria that correspond to the clinical trial below.
Title: Evaluation of the Efficacy of Spa Treatment for Prevention of Leg Ulcers in Advanced Chronic Venous Insufficiency.
Brief Summary: The main objective of this study is to test the hypothesis that a 3 week intensive course of spa therapy can reduce the risk of leg ulcers in patients with advanced chronic venous insufficiency (C4a-b and C5 of the CEAP classification) at one year.


Options:
A: Inclusion Criteria:

* Diagnosis of venous insufficiency between 18-75 years with duplex ultrasound imaging
* CEAP classification used in venous insufficiency is C2-C3-C4-C5
* Having written and verbal communication in Turkish

Exclusion Criteria:

* Acute deep vein thrombosis
* The presence of ulceration
* Being in class III and IV according to the New York Heart Association classification
* Presence of respiratory failure
* Undergoing chemotherapy due to the presence of any cancer
* Being in the process of treatment for neurological, orthopedic or rheumatologic diseases including lower extremity
B: Inclusion Criteria:

* patients aged 18 to 80 years with chronic venous insufficiency regardless of etiology stages 3 or 4 according to the CEAP classification (Clinical severity, Etiology or cause, Anatomy, Pathophysiology)
* Patients available to participate in a 3 weeks session in the spa center and to be followed for 6 months

Exclusion Criteria:

* pregnant women,
* contra-indication for the spa treatment (chronic infectious diseases, cancer, heart failure, serious liver or kidney disease, open leg ulcer, psychiatric disorders, immune deficiency, phlebitis, erysipelas or history of erysipelas);
* surgery in the next three months,
* spa treatment in the previous 6 months,
* professional involvement with a spa resort
C: Inclusion Criteria:

* A radiologically confirmed, acute, proximal first lower extremity DVT
* 4 to 8 weeks after starting anticoagulation
* Out-patient ambulatory status

Exclusion Criteria:

* Contraindication to increasing activity such as patients with juvenile arthritis, poor balance, congestive heart failure, etc.
D: Inclusion Criteria:

* Both sexes, more than 18 years old patients with a phlebological indication of spa treatment, with advanced chronic venous insufficiency, class C4a, or b or C5 of CEAP classification (leg ulcers must be healed since 3 months at least)
* Available for a spa treatment during 18 days (immediate or late spa)and a follow-up period of 18 months
* Voluntary to participate to the study,informed consent form signed after appropriate information
* Affiliation to the social security system or equivalent

Exclusion Criteria:

* Pregnancy, parturient or breast feeding
* No psychiatric illness or social situation that would preclude study compliance
* Leg ulcer in progress
* Leg ulcer healed for less than 3 months
* Refusal to consent
* Refusal of spa treatment
* Contra-indication of spa treatment(cancer in progress, psychiatric disorders, immunodeficiency)
* Arteriopathy of lower limb with an Ankle Brachial Pressure Index (ABPI)\< 0.7, symptomatic neuropathy, erysipelas within 5 years prior to inclusion
* Surgical or endovascular treatment of the venous disease planned during the first year or during the six months prior to inclusion
* No previous phlebological spa treatment within 6 months prior to inclusion

Answer: D