The great saphenous vein (GSV, alternately "long saphenous vein"; ) is a large, subcutaneous,
superficial vein 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 c ...
. 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 a separate organ at the terminal part of the leg made ...
,
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 c ...
and
thigh to the
deep femoral vein
In the human body, the femoral vein is a blood vessel that accompanies the femoral artery in the femoral sheath. It begins at the adductor hiatus (an opening in the adductor magnus muscle) as the continuation of the popliteal vein. It ends at ...
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 rot ...
.
Structure
The great saphenous vein originates from where the dorsal vein of the
big toe (the hallux) merges with the
dorsal venous arch of the foot
The dorsal venous arch of the foot is a superficial vein that connects the small saphenous vein and the great saphenous vein. Anatomically, it is defined by where the dorsal veins of the first and fifth digit, respectively, meet the great saphen ...
. After passing in front of the
medial malleolus (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 side of the leg.
At the
knee, it runs over the posterior border of the
medial epicondyle of the femur 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 the ...
, the great saphenous vein dives down deep through the
cribriform fascia
The cribriform fascia, fascia cribrosa also Hesselbach's fascia is the portion of fascia covering the saphenous opening in the thigh. It is perforated by the great saphenous vein and by numerous blood and lymphatic vessels. (A structure in anatomy ...
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 a blood vessel that accompanies the femoral artery in the femoral sheath. It begins at the adductor hiatus (an opening in the adductor magnus muscle) as the continuation of the popliteal vein. It ends at th ...
in the region of 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 rot ...
at the sapheno-femoral junction.
Tributaries
Several veins join the great saphenous vein, but each of them is not 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 a blood vessel that accompanies the femoral artery in the femoral sheath. It begins at the adductor hiatus (an opening in the adductor magnus muscle) as the continuation of the popliteal vein. It ends at ...
(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 long saphenous vein.
See also
* Lateral marginal vein
References
Veins of the lower limb
{{cardiovascular-stub ...
; 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 veins (Cockett perforators) with the
anterior
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...
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
femoral vein
In the human body, the femoral vein is a blood vessel that accompanies the femoral artery in the femoral sheath. It begins at the adductor hiatus (an opening in the adductor magnus muscle) as the continuation of the popliteal vein. It ends at ...
by perforator veins (Dodd perforator) and receives numerous tributaries; those from the medial and posterior parts of the
thigh frequently unite to form a large
accessory saphenous vein
The anterior accessory saphenous vein is a special anterior tributary of the great saphenous vein (GSV), draining the antero-lateral face of the thigh.
It becomes very often insufficient, causing important varicose veins with an autonomous cou ...
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, and
superficial external pudendal veins.
The
thoracoepigastric vein runs along the lateral aspect of the trunk between the
superficial epigastric vein
Superficial may refer to:
*Superficial anatomy, is the study of the external features of the body
*Superficiality, the discourses in philosophy regarding social relation
*Superficial charm, the tendency to be smooth, engaging, charming, slick and ...
below and the
lateral thoracic vein
The lateral thoracic vein (sometimes debatably referred to as the long thoracic vein) is a tributary of the axillary vein. It runs with the lateral thoracic artery and drains the Serratus anterior muscle and the Pectoralis major muscle.
Norma ...
above and establishes an important communication between the
femoral vein
In the human body, the femoral vein is a blood vessel that accompanies the femoral artery in the femoral sheath. It begins at the adductor hiatus (an opening in the adductor magnus muscle) as the continuation of the popliteal vein. It ends at ...
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 ...
.
Clinical significance
Pathology 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. These veins typically develop in the legs, just under the skin. Varicose veins usually cause few symptoms. However, some indi ...
s: The great saphenous vein, like other
superficial veins, 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 s ...
: The GSV can
thrombose. This type of
phlebitis 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 which must be treated promptly. So a GSV thrombosis is investigated by
ultrasonography to detect if these complications are present.
[
]
Use in cardiovascular procedures
The vein is often removed by cardiac surgeon
Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease (for example, with coronary artery bypass grafting); to corr ...
s 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, autogen ...
in coronary artery bypass operations, when arterial grafts are not available or many grafts are required, such as in a triple bypass or 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 pai ...
.
The great saphenous vein is the conduit of choice for vascular surgeons, when available, for performing peripheral arterial bypass operations see_vascular_bypass_.html" ;"title="vascular_bypass.html" ;"title="see vascular bypass">see vascular bypass ">vascular_bypass.html" ;"title="see vascular bypass">see vascular bypass The saphenous vein may undergo vein graft failure after engraftment, but still 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 situ'' (; often not italicized in English) is a Latin phrase that translates literally to "on site" or "in position." It can mean "locally", "on site", "on the premises", or "in place" to describe where an event takes place and is used in ...
'' (in place), after tying off smaller tributaries and destruction of the venous valves
Veins are blood vessels in 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 the pulmonary and umbilical veins, both of which carry oxygenated ...
with a device called valvulotome
A valvulotome is a catheter-based controllable surgical instrument used for cutting or disabling the venous valves. This is needed to enable an in situ bypass in patients with an occluded artery (especially femoral artery), where the saphenous ve ...
, e.g. LeMaitre's valvulotome.
Removal of the saphenous vein will not 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 circulation around a blocked artery or vein via another path, such as nearby minor vessels. It may occur via preexisting vascular redundancy (analogous to engineered redundancy), as in the circle of Wil ...
.
The saphenous nerve 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.
Structure
The femoral nerve is the major nerve supplying the anterior compartment of the thigh. It is the largest ...
that runs with the great saphenous vein and can be damaged in surgery on the vein.
Use in emergency medicine
When emergency resuscitation with fluids is necessary, and standard intravenous 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") and "safoon" (Hebrew, "שָׂפוּן" meaning "hidden/covered") 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).
See also
* Coronary artery bypass grafting
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 pa ...
(CABG)
* Saphena varix A saphena varix, or saphenous varix, is a dilation of the saphenous vein at its junction with the femoral vein in the groin. It is a common surgical problem, and patients may present with groin swelling.
Clinical features
It displays a cough impu ...
* Varicose vein
Varicose veins, also known as varicoses, are a medical condition in which superficial veins become enlarged and twisted. These veins typically develop in the legs, just under the skin. Varicose veins usually cause few symptoms. However, some indi ...
s
References
External links
Great saphenous vein
- Stedman's medical dictionary.
*
*
*
{{Authority control
Veins of the lower limb