The great saphenous vein is the longest vein in the body, running from the medial foot to the femoral vein in the groin, and is the most important superficial vein for surgical access and vascular grafting. Its consistent medial course and accessibility make it the standard conduit for coronary artery bypass grafting and infrainguinal arterial bypass procedures. Varicose veins most commonly involve the great saphenous vein territory from saphenofemoral junction incompetence.
| Origin | Medial marginal vein of the foot at the medial malleolus |
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Great saphenous vein varicosities are treated with endovenous laser or radiofrequency ablation of the incompetent GSV from saphenofemoral junction to below knee, replacing the traditional stripping procedure. The GSV is accessed for emergency venous cutdown when peripheral IV access fails, at the anteromedial ankle just anterior to the medial malleolus. Before coronary artery bypass, GSV mapping by ultrasound assesses diameter and patency for graft harvest planning.
Valve failure at the GSV-femoral vein junction producing downward reflux and varicose vein development managed with endovenous ablation or high tie and stripping procedures.
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