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 |
|---|---|
| Course | Ascends medially, passes posterior to the medial knee, ascends the medial thigh, and passes through the saphenous opening in the fascia lata to join the femoral vein at the saphenofemoral junction |
| Branches |
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Great saphenous vein varicosities are treated with endovenous laser or radiofrequency ablation of the incompetent vein from the saphenofemoral junction to below the knee, which gives results equal to surgical stripping with less pain and faster recovery. The vein is used for emergency venous cutdown just in front of the medial malleolus when other access fails. Before coronary or peripheral bypass, ultrasound mapping checks its diameter and patency for harvest. The saphenous nerve runs alongside the vein below the knee, so stripping, ablation or harvest in the leg can cause medial leg and foot numbness.
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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