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((Short description|Large, subcutaneous, superficial vein of the leg))
((more citations needed|date=November 2013))
((Infobox vein
| Name        = Great saphenous vein
| Latin       = vena saphena magna
| Image       = Great_saphenous_vein.png
| Caption     = The great saphenous vein and landmarks along its course from the [[dorsal venous arch]] to the saphenous opening and [[femoral vein]]
| 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      =
))
The '''great saphenous vein''' '''(GSV)''', or '''long saphenous vein'''; ((IPAc-en|s|ə|ˈ|f|iː|n|ə|s))) is a large, subcutaneous, [[superficial vein]] of the [[human leg|leg]]. It is the longest vein in the body, running along the length of the lower limb, returning blood from the [[foot]], [[human leg|leg]] and [[thigh]] to the [[deep femoral vein]] at the [[femoral triangle]].

==Structure==
The great saphenous vein originates from where the dorsal vein of the [[toe|big toe]] (the hallux) merges with the [[dorsal venous arch of the foot]]. After passing in front of the [[medial malleolus]] (where it often can be visualized and [[Palpation|palpated]]), it runs up the [[medial (anatomy)|medial]] side of the leg.<ref name=":0">((Citation|last=Ricci|first=Stefano|title=1 - Anatomy|date=2017-01-01|url=http://www.sciencedirect.com/science/article/pii/B9780323377263000010|work=Sclerotherapy (Sixth Edition)|pages=1–26|editor-last=Goldman|editor-first=Mitchel P.|publisher=Elsevier|language=en|doi=10.1016/b978-0-323-37726-3.00001-0|isbn=978-0-323-37726-3|access-date=2020-11-19|editor2-last=Weiss|editor2-first=Robert A.))</ref> At the [[knee]], it runs over the posterior border of the [[medial epicondyle of the femur]] bone. In the proximal anterior thigh ((Convert|3–4|cm|in)) inferolateral to the [[pubic tubercle]], the great saphenous vein dives down deep through the [[cribriform fascia]] of the saphenous opening to join the femoral vein. It forms an arch, the saphenous arch, to join the [[common femoral vein]] in the region of the [[femoral triangle]] at the sapheno-femoral junction.<ref name=":0" />

===Tributaries===
[[File:Gray584.png|thumb|left|150px|Superficial veins draining into the great saphenous and femoral vein.]]
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]] (CFV), at various average distances from this junction:<ref name="MühlbergerMorandini2009">((cite journal|last1=Mühlberger|first1=Dominic|last2=Morandini|first2=Luca|last3=Brenner|first3=Erich|title=Venous valves and major superficial tributary veins near the saphenofemoral junction|journal=Journal of Vascular Surgery|volume=49|issue=6|year=2009|pages=1562–1569|issn=0741-5214|doi=10.1016/j.jvs.2009.02.241|pmid=19497520|doi-access=free))</ref>

{|class="wikitable"
! Vein<ref name="MühlbergerMorandini2009"/> !! Presence<ref name="MühlbergerMorandini2009"/> !! Joins from direction<ref name="MühlbergerMorandini2009"/> !! Joins at average distance from CFV junction<ref name="MühlbergerMorandini2009"/>
|-
| [[Superficial circumflex iliac vein]] || 83% || Lateral || 10.8&nbsp;mm
|-
| [[Superficial epigastric vein]] || 78% || Proximal || 11.9&nbsp;mm
|-
| [[Superficial external pudendal vein]] || 90% || Medial || 16.9&nbsp;mm
|-
| [[Anterior accessory saphenous vein]] || 51% || Lateral || 20.5&nbsp;mm
|-
| [[Posterior accessory saphenous vein]] || ||  || 73.9&nbsp;mm
|}

At the ankle, the great saphenous vein 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 by [[perforator vein]]s (Cockett perforators) with the [[anterior tibial vein|anterior]] and [[Posterior tibial vein|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]] 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]] which joins the main vein near the sapheno-femoral junction.<ref name="Franceschi & Zamboni">((cite book|title=Principles of Venous Hemodynamics|author=Franceschi, C.|author2=Zamboni, P.|pages=12–13|publisher=Nova biomedical Books|year=2009|isbn=978-1-60692-485-3))</ref>

Near the [[saphenous opening|fossa ovalis]] it is joined by the [[superficial epigastric vein|superficial epigastric]], [[superficial circumflex iliac vein]], and [[External pudendal vein|superficial external pudendal]] veins.

The [[thoracoepigastric vein]] 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 vein]] and the [[axillary vein]].

==Clinical significance==
[[Pathology]] of the great saphenous vein is relatively common, but in isolation typically not life-threatening.<ref name=feied>((EMedicine|article|463256|Superficial Thrombophlebitis))</ref>
* [[Varicose vein]]s: The great saphenous vein, like other [[superficial vein]]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]]: The GSV can [[thrombosis|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.<ref name=feied/>

===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>((cite journal |doi=10.1007/s11892-005-0063-7 |title=Peripheral arterial disease: Clinical assessment and indications for revascularization in the patient with diabetes |year=2005 |last1=Muhs |first1=Bart E. |last2=Gagne |first2=Paul |last3=Sheehan |first3=Peter |journal=Current Diabetes Reports |volume=5 |pages=24–9 |pmid=15663913 |issue=1|s2cid=28526956 ))</ref>  when available, for performing peripheral arterial bypass operations [ 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 graft]]s or biosynthetic grafts [Omniflow].  Often, it is used ''[[in situ]]'' (in place), after tying off smaller tributaries and destruction of the [[venous valves]] 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]].

The [[saphenous nerve]] that runs with the upper part of the great saphenous vein is a branch of the [[femoral nerve]]. It 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, [[Venous cutdown|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")<ref name="pmid11802151">((cite journal |last1=Caggiati |first1=Alberto |last2=Bergan |first2=John J. |title=The saphenous vein: derivation of its name and its relevant anatomy |journal=Journal of Vascular Surgery |volume=35 |issue=1 |pages=172–5 |year=2002 |pmid=11802151 |doi=10.1067/mva.2002.118826 |doi-access=free ))</ref> have been claimed as the origin for the word "saphenous".<ref name="pmid11802151"/>

==Additional images==
<gallery>
 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).
</gallery>

==See also==
((Anatomy-terms))
* [[CABG|Coronary artery bypass grafting]] (CABG)
* [[Saphena varix]]
* [[Varicose vein]]s

==References==
((Reflist|2))

==External links==
*[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))
((Authority control))

[[Category:Veins of the lower limb]]

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