- Great saphenous vein
Name = Great saphenous vein
Latin = vena saphena magna
GraySubject = 173
GrayPage = 669
Caption = The great saphenous vein and landmarks along its course
Caption2 = The great saphenous vein and its tributaries at the fossa ovalis in the
dorsal venous arch of the foot, and others
MeshName = Saphenous+Vein
MeshNumber = A07.231.908.819
DorlandsPre = v_05
DorlandsSuf = 12851675
The great saphenous vein (GSV), also greater saphenous vein, is the large (subcutaneous)
superficial veinof the legand thigh. First described by the Persian physician Avicennain the 11th century, it derives its name from the term 'Safin' meaning hidden. It travels mostly in its own fascial compartment in the thigh and is hence 'hidden'.
The GSV originates from where the dorsal vein of the
first digit(the large toe) merges with the dorsal venous arch of the foot.
After passing anterior to the
medial malleolus(where it often can be visualized and palpated), it runs up the medialside of the leg.
At the knee, it runs over the posterior border of the
medial epicondyleof the femur bone.
The great saphenous vein then courses laterally to lie on the anterior surface of the thigh before entering an opening in the
fascia latacalled the saphenous opening.
It joins with the
femoral veinin the region of the femoral triangle.
At the ankle it receives branches from the sole of the foot through the
medial marginal vein; in the lower leg it anastomoses freely with the small saphenous vein, communicates with the anterior and posterior tibial veins and receives many cutaneous veins; in the thigh it communicates with the femoral veinand receives numerous tributaries; those from the medial and posterior parts of the thighfrequently unite to form a large "accessory saphenous vein" which joins the main vein at a variable level.
Near the fossa ovalis it is joined by the
superficial epigastric, superficial iliac circumflex, and superficial external pudendalveins.
A vein, named the "thoracoepigastric", runs along the lateral aspect of the trunk between the
superficial epigastric veinbelow and the lateral thoracic veinabove and establishes an important communication between the femoraland axillaryveins.
Use in cardiovascular procedures
The vein is often removed by
cardiac surgeons and used for autotransplantationin coronary artery bypass operations, when arterial grafts are not available or many grafts are required, such as in a triple bypassor quadruple bypass.
The great saphenous vein is the conduit of choice for
vascular surgeons, [Muhs BE, Gagne P, Sheehan P. Peripheral arterial disease: clinical assessment and indications for revascularization in the patient with diabetes. Curr Diab Rep. 2005 Feb;5(1):24-9. PMID 15663913.] [Mamode N, Scott RN. Graft type for femoro-popliteal bypass surgery. Cochrane Database Syst Rev. 2000;(2):CD001487. PMID 10796649.] when available, for doing peripheral arterial bypassoperations because it has superior long-term patency compared to synthetic grafts ( PTFE, PETE(Dacron)), human umbilical vein grafts or biosynthetic grafts [Omniflow] . Often, it is used " in situ" (in place), after tying off smaller tributaries and stripping the valveswith a device called LeMaitre's valvulotome.
saphenous nerveis a branch of the femoral nervethat runs with the great saphenous vein and is often damaged in surgeries that make use of the similarly named vein.
When emergency resuscitation with fluids is necessary, and standard
intravenousaccess can not be achieved due to venous collapse, saphenous vein cutdown may be necessary.
Pathology of the saphenous vein
Pathologyof the great saphenous vein is relatively common, but in isolation typically not life threatening.Feied C, Handler JA. Thrombophlebitis, Superficial. eMedicine.com. Available at: [http://www.emedicine.com/emerg/topic582.htm http://www.emedicine.com/emerg/topic582.htm] . Accessed on: December 18, 2006.]
Varicose veins: The great saphenous vein, like other superficial veins, can develop varices, which are generally considered to be unsightly. Various treatment options exist for treating varicose veins. Varicose veins are not life threatening.
Phlebitis: The great saphenous vein can become infected.
Thrombophlebitis: The great saphenous vein can thrombose and become infected. Thrombophlebitis of the great saphenous vein is not life threatening in isolation; however, it may be associated with deep vein thrombosiswhich can be and thus requires further investigation.
*Coronary artery bypass grafting (CABG)
* - "The arteries of the lower extremity" -
* - "The veins of the lower extremity, abdomen, and pelvis" -
* [http://www.answers.com/topic/great-saphenous-vein Great saphenous vein] - Stedman's medical dictionary.
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