The great saphenous vein (GSV; ) or long saphenous vein is a large, subcutaneous,

superficial vein Superficial veins are veins that are close to the surface of the body, as opposed to deep veins, which are far from the surface. Superficial veins are not paired with an artery, unlike the deep veins, which are typically associated with an art ...

of the

leg A leg is a weight-bearing and locomotive anatomical structure, usually having a columnar shape. During locomotion, legs function as "extensible struts". The combination of movements at all joints can be modeled as a single, linear element cap ...

. It is the longest vein in the body, running along the length of the lower limb, returning blood from the

foot The foot (: feet) is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is an organ at the terminal part of the leg made up o ...

, and

thigh In anatomy, the thigh is the area between the hip (pelvis) and the knee. Anatomically, it is part of the lower limb. The single bone in the thigh is called the femur. This bone is very thick and strong (due to the high proportion of bone tissu ...

to the

deep femoral vein The deep femoral vein, deep vein of the thigh or profunda femoris vein is a large deep vein in the thigh. It collects blood from the inner thigh, passing superiorly and medially alongside the deep femoral artery before emptying into the femoral ...

at the

femoral triangle The femoral triangle (or Scarpa's triangle) is an anatomical region of the upper third of the thigh. It is a subfascial space which appears as a triangular depression below the inguinal ligament when the thigh is flexed, abducted and laterally r ...

Structure

The great saphenous vein originates from where the dorsal vein of the

big toe Toes are the Digit (anatomy), digits of the foot of a tetrapod. Animal species such as cats that walk on their toes are described as being ''digitigrade''. Humans, and other animals that walk on the soles of their feet, are described as being ' ...

(the hallux) merges with the dorsal venous arch of the foot. After passing in front of the

medial malleolus A malleolus is the bony prominence on each side of the human ankle. Each leg is supported by two bones, the tibia on the inner side (medial) of the leg and the fibula on the outer side (lateral) of the leg. The medial malleolus is the promin ...

(where it often can be visualized and

palpated Palpation is the process of using one's hands to check the body, especially while perceiving/diagnosing a disease or illness. Usually performed by a health care practitioner, it is the process of feeling an object in or on the body to determine ...

), it runs up the

medial Medial may refer to: Mathematics * Medial magma, a mathematical identity in algebra Geometry * Medial axis, in geometry the set of all points having more than one closest point on an object's boundary * Medial graph, another graph that repr ...

side of the leg. At the

knee In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). It is the largest joint in the hu ...

, it runs over the posterior border of the

medial epicondyle of the femur The medial epicondyle of the femur is an epicondyle, a bony protrusion, located on the medial side of the femur at its distal end. Located above the medial condyle, it bears an elevation, the adductor tubercle,Platzer (2004), p 192 which serve ...

bone. In the proximal anterior thigh inferolateral to the

pubic tubercle The pubic tubercle is a prominent tubercle on the superior ramus of the pubis bone of the pelvis. Structure The pubic tubercle is a prominent forward-projecting tubercle on the upper border of the medial portion of the superior ramus of th ...

, the great saphenous vein dives down deep through the

cribriform fascia The cribriform fascia (also known as the fascia cribrosa, or Hesselbach's fascia) is the portion of the superficial layer of the deep fascia of leg which extends between the sartorius muscle, adductor longus muscle, and inguinal ligament to form ...

of the saphenous opening to join the femoral vein. It forms an arch, the saphenous arch, to join the

common femoral vein In the human body, the femoral vein is the vein that accompanies the femoral artery in the femoral sheath. It is a deep vein that begins at the adductor hiatus (an opening in the adductor magnus muscle) as the continuation of the popliteal vein. ...

in the region of the

at the sapheno-femoral junction.

Tributaries

Several veins join the great saphenous vein, but may not all present in every individual. Most of them join it near its junction with the common

femoral vein In the human body, the femoral vein is the vein that accompanies the femoral artery in the femoral sheath. It is a deep vein that begins at the adductor hiatus (an opening in the adductor magnus muscle) as the continuation of the popliteal v ...

(CFV), at various average distances from this junction: At the ankle, the great saphenous vein receives branches from the sole of the foot through the

medial marginal vein The medial marginal vein is a continuation of the dorsal venous arch of the foot and is the origin of the great saphenous vein The great saphenous vein (GSV; ) or long saphenous vein is a large, subcutaneous, superficial vein of the human leg ...

; in the lower leg it anastomoses freely with the

small saphenous vein The small saphenous vein (also short saphenous vein or lesser saphenous vein) is a relatively large superficial vein of the posterior leg. Structure The origin of the small saphenous vein (SSV) is where the dorsal vein from the fifth digit (smal ...

, communicates by

perforator vein Perforator veins are so called because they perforate the deep fascia of muscles, to connect the superficial veins to the deep veins where they drain. Perforator veins play an essential role in maintaining normal blood draining. They have venous ...

s (Cockett perforators) with the

anterior Standard anatomical terms of location are used to describe unambiguously the anatomy of humans and other animals. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...

and posterior tibial veins and receives many cutaneous veins; near the knee it communicates with the popliteal vein by the Boyd perforator, in the thigh it communicates with the

by perforator veins (Dodd perforator) and receives numerous tributaries; those from the medial and posterior parts of the

frequently unite to form a large accessory saphenous vein which joins the main vein near the sapheno-femoral junction. Near the fossa ovalis it is joined by the superficial epigastric,

superficial circumflex iliac vein Superficial circumflex iliac vein is either of the two venae comitantes of the superficial circumflex iliac artery. It usually empties into the great saphenous vein just proximal to where it itself empties into the femoral vein, but may sometimes ...

, and superficial external pudendal veins. The thoracoepigastric vein runs along the lateral aspect of the trunk between the

superficial epigastric vein The superficial epigastric vein is a vein Veins () are blood vessels in the circulatory system of humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; ex ...

below and the lateral thoracic vein above and establishes an important communication between the

and the

axillary vein In human anatomy, the axillary vein is a large blood vessel that conveys blood from the lateral aspect of the thorax, axilla (armpit) and upper limb toward the heart. There is one axillary vein on each side of the body. Structure Its origin i ...

Clinical significance

Pathology Pathology is the study of disease. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatme ...

of the great saphenous vein is relatively common, but in isolation typically not life-threatening. *

Varicose vein Varicose veins, also known as varicoses, are a medical condition in which superficial veins become enlarged and twisted. Although usually just a cosmetic ailment, in some cases they cause fatigue, pain, itching, and nighttime leg cramps. These ve ...

s: The great saphenous vein, like other

s, can become varicose; swollen, twisted and lengthened, and generally considered to be unsightly. Varicose veins are not life-threatening and various treatment options are available. However, when the diameter of the vein is too large for the valves within it to coapt completely, the resulting condition, chronic venous insufficiency, can result in skin color changes in the calf and ulcers that may persist for years if the vein is not ablated. *

Thrombophlebitis Thrombophlebitis is a phlebitis (inflammation of a vein) related to a thrombus (blood clot). When it occurs repeatedly in different locations, it is known as thrombophlebitis migrans (migratory thrombophlebitis). Signs and symptoms The following ...

: The GSV can thrombose. This type of

phlebitis Phlebitis (or venitis) is inflammation of a vein, usually in the legs. It most commonly occurs in superficial veins. Phlebitis often occurs in conjunction with thrombosis (clotting inside blood vessels) and is then called thrombophlebitis or ...

of the GSV is usually not life-threatening in isolation; however, if the blood clot is located near the sapheno-femoral junction or near a perforator vein, a clot fragment can migrate to the deep venous system and to the pulmonary circulation. Also it can be associated with, or progress to a

deep vein thrombosis Deep vein thrombosis (DVT) is a type of venous thrombosis involving the formation of a blood clot in a deep vein, most commonly in the legs or pelvis. A minority of DVTs occur in the arms. Symptoms can include pain, swelling, redness, and enl ...

which must be treated promptly. So a GSV thrombosis is investigated by

ultrasonography Medical ultrasound includes diagnostic techniques (mainly imaging) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscles, joints, ...

to detect if these complications are present.

Use in cardiovascular procedures

The vein is often removed by cardiac surgeons and used for

autotransplantation Autotransplantation is the transplantation of organs, tissues, or even particular proteins from one part of the body to another in the same person ('' auto-'' meaning "self" in Greek). The autologous tissue (also called autogenous, autogenei ...

in coronary artery bypass operations, when arterial grafts are not available or many grafts are required, such as in a

triple bypass Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage"), is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve Angina ...

quadruple bypass Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage"), is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest p ...

. The great saphenous vein is the conduit of choice for

vascular surgeon Vascular surgery is a surgical subspecialty in which vascular diseases involving the arteries, veins, or lymphatic vessels, are managed by medical therapy, minimally-invasive catheter procedures and surgical reconstruction. The specialty evolve ...

s, when available, for performing peripheral arterial bypass operations. The saphenous vein may undergo vein graft failure after engraftment, but still it has superior long-term patency compared to synthetic grafts (

PTFE Polytetrafluoroethylene (PTFE) is a synthetic fluoropolymer of tetrafluoroethylene, and has numerous applications because it is chemically inert. The commonly known brand name of PTFE-based composition is Teflon by Chemours, a spin-off fro ...

, PETE (Dacron)),

human umbilical vein graft A vascular bypass is a surgical procedure performed to redirect blood flow from one area to another by reconnecting blood vessels. Often, this is done to bypass around a diseased artery, from an area of normal blood flow to another relatively norm ...

s or biosynthetic grafts mniflow Often, it is used ''

in situ is a Latin phrase meaning 'in place' or 'on site', derived from ' ('in') and ' ( ablative of ''situs'', ). The term typically refers to the examination or occurrence of a process within its original context, without relocation. The term is use ...

'' (in place), after tying off smaller tributaries and destruction of the

venous valves Veins () are blood vessels in the circulatory system of humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are those of the pulmonary and fetal c ...

with a device called valvulotome, e.g. LeMaitre's valvulotome. Removal of the saphenous vein will not materially hinder normal circulation in the leg. The blood that previously flowed through the saphenous vein will change its course of travel. This is known as

collateral circulation Collateral circulation is the alternate Circulatory system, circulation around a blocked blood vessel, artery or vein via another path, such as nearby minor vessels. It may occur via preexisting vascular redundancy (analogous to redundancy (engi ...

. The

saphenous nerve The saphenous nerve (long or internal saphenous nerve) is the largest cutaneous branch of the femoral nerve. It is derived from the lumbar plexus (L3-L4). It is a strictly sensory nerve, and has no motor function. It commences in the proximal (u ...

that runs with the upper part of the great saphenous vein is a branch of the

femoral nerve The femoral nerve is a nerve in the thigh that supplies skin on the upper thigh and inner leg, and the muscles that extend the knee. It is the largest branch of the lumbar plexus. Structure The femoral nerve is the major nerve supplying the ant ...

. It can be damaged in surgery on the vein.

Use in emergency medicine

When emergency resuscitation with fluids is necessary, and standard

intravenous Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous route of administration is commonly used for rehydration or to provide nutr ...

access cannot be achieved due to venous collapse, saphenous vein cutdown may be utilized.

Etymology

The terms "saphaina" (Greek, meaning "manifest", "to be clearly seen") as well as "safin" (Arabic, "صَافِن" meaning "deep/embedded") have been claimed as the origin for the word "saphenous".

Additional images

File:Slide2por.JPG, Superficial veins of lower limb. Superficial dissection. Anterior view. File:Slide2che.JPG, Great saphenous vein. Deep dissection. Anterior view. File:Blausen 0609 LegVeins.png, Illustration depicting veins of the leg including great saphenous vein (anterior view).

References

External links

Great saphenous vein
- Stedman's medical dictionary. * * * {{Authority control Veins of the lower limb