Great saphenous vein
|Vein: Great saphenous vein|
|The great saphenous vein and landmarks along its course|
|The great saphenous vein and its tributaries at the fossa ovalis in the groin.|
|Latin||vena saphena magna|
|Gray's||subject #173 669|
|Source||dorsal venous arch of the foot, and others|
|Drains to||femoral vein|
At the knee, it runs over the posterior border of the medial epicondyle of the femur bone.
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 vein and receives numerous tributaries; those from the medial and posterior parts of the thigh frequently unite to form a large accessory saphenous vein which joins the main vein at a variable level.
A vein, named the thoracoepigastric, runs along the lateral aspect of the trunk between the superficial epigastric vein below and the lateral thoracic vein above and establishes an important communication between the femoral and axillary veins.
Use in cardiovascular procedures
The vein is often removed by cardiac surgeons and used for autotransplantation 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.
The great saphenous vein is the conduit of choice for vascular surgeons, when available, for doing peripheral arterial bypass operations 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 valves with a device called LeMaitre's valvulotome.
Pathology of the saphenous vein
- 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.
- 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 thrombosis which can be and thus requires further investigation.
- 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.
- Feied C, Handler JA. Thrombophlebitis, Superficial. eMedicine.com. Available at: http://www.emedicine.com/emerg/topic582.htm. Accessed on: December 18, 2006.
- Gray's s157 - "The arteries of the lower extremity" - Gray's Anatomy.
- Gray's s173 - "The veins of the lower extremity, abdomen, and pelvis" - Gray's Anatomy.
- Great saphenous vein - Stedman's medical dictionary.
- SUNY Labs 11:02-0102
- SUNY Labs 11:03-0105
- Mnemonic at medicalmnemonics.com 278