Great saphenous vein
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{{Infobox Vein |
Name = Great saphenous vein |
Latin = vena saphena magna |
GraySubject = 173 |
GrayPage = 669 |
Image = Great_saphenous_vein.png |
Caption = The great saphenous vein and landmarks along its course |
Image2 = Gray580.png |
Caption2 = The great saphenous vein and its tributaries at the [[Saphenous opening|fossa ovalis]] in the [[groin]].|
DrainsFrom = |
Source = [[dorsal venous arch of the foot]], and others |
DrainsTo = [[femoral vein]] |
Artery = |
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 vein]] of the [[leg]] and [[thigh]]. First described by the [[Persian Empire|Persian]] physician [[Avicenna]] in 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'.
==Path==
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 [[Palpation|palpated]]), 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.
The great saphenous vein then courses laterally to lie on the anterior surface of the thigh before entering an opening in the [[fascia lata]] called the [[saphenous opening]].
It joins with the [[femoral vein]] in the region of the [[femoral triangle]].
==Tributaries==
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 tibial vein|anterior]] and [[Posterior tibial vein|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.
Near the [[saphenous opening|fossa ovalis]] it is joined by the [[superficial epigastric]], [[superficial iliac circumflex]], and [[superficial external pudendal]] veins.
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 surgeon]]s and used for [[autotransplantation]] in [[Coronary artery bypass surgery|coronary artery bypass operation]]s, 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 surgeon]]s,<ref>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.</ref><ref>Mamode N, Scott RN. Graft type for femoro-popliteal bypass surgery. Cochrane Database Syst Rev. 2000;(2):CD001487. PMID 10796649.</ref> 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 graft]]s 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]].
The [[saphenous nerve]] is a branch of the [[femoral nerve]] that runs with the great saphenous vein and is often damaged in surgeries that make use of the similarly named vein.
==Use in [[emergency medicine]]==
When emergency resuscitation with fluids is necessary, and standard [[intravenous]] access can not be achieved due to venous collapse, [[Venous cutdown|saphenous vein cutdown]] may be necessary.
==Pathology of the saphenous vein==
[[Pathology]] of the great saphenous vein is relatively common, but in isolation typically not life threatening.<ref name=feied>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.
</ref>
* [[Varicose vein]]s: The great saphenous vein, like other [[superficial vein]]s, can develop [[varix|varices]], which are generally considered to be unsightly. Various treatment options exist for treating [[varicose vein]]s. Varicose veins are not life threatening.
* [[Phlebitis]]: The great saphenous vein can become [[infection|infected]].
* [[Thrombophlebitis]]: The great saphenous vein can [[thrombosis|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.<ref name=feied/>
==See also==
*[[CABG|Coronary artery bypass grafting]] (CABG)
*[[Varicose vein]]s
==Additional images==
<gallery>
Image:Gray432 color.png|Cross-section through the middle of the thigh.
Image:Gray440_color.png|Cross-section through middle of leg.
Image:Gray545.png|Femoral sheath laid open to show its three compartments.
Image:Gray582.png|Small saphenous vein and its tributaries.
Image:Gray584.png|The femoral vein and its tributaries.
</gallery>
==References==
{{reflist}}
==External links==
* {{GraySubject|157}} - "The arteries of the lower extremity" - [[Gray's Anatomy]].
* {{GraySubject|173}} - "The veins of the lower extremity, abdomen, and pelvis" - [[Gray's Anatomy]].
*[http://www.answers.com/topic/great-saphenous-vein Great saphenous vein] - Stedman's medical dictionary.
* {{SUNYAnatomyLabs|11|02|01|02}}
* {{SUNYAnatomyLabs|11|03|01|05}}
* {{MedicalMnemonics|278|||}}
{{VeinsExtremities}}
[[Category:Pelvic limb anatomy]]
[[Category:Veins]]
[[fr:Veine grande saphène]]
[[la:Vena saphena magna]]
[[nl:Vena saphena magna]]
[[pt:Veia safena magna]]