Great saphenous vein 239687 212429902 2008-05-14T20:08:58Z Sbmehta 765172 grammar/style cleanup {{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]]