Great saphenous vein

At a glance

English

Great saphenous vein

Latin (TA2)

Vena saphena magna

System

Vein

Region

Foot

Side

Paired, left and right

About the great saphenous vein

The great saphenous vein, also called the long saphenous vein, is the body's longest vein. It lies in the subcutaneous tissue, outside the deep fascia, for almost its whole course and returns superficial blood of the whole limb, from foot to thigh, to the deep venous system at the groin. It begins at the medial end of the foot's dorsal venous arch, where the arch meets the dorsal digital vein from the inner side of the great toe and the medial marginal vein.

From there it passes upwards just anterior to the medial malleolus, a reliable spot where it can be seen and felt. It climbs the inner leg alongside the saphenous nerve, crosses behind the medial condyles at the knee, roughly a hand's breadth behind the medial border of the patella, and then runs up the medial and front aspect of the thigh. Below the groin it passes through the cribriform fascia covering the saphenous opening and curves backwards and downwards as the saphenous arch to empty into the femoral vein at the saphenofemoral junction, inside the femoral triangle.

Along the way it receives many skin veins and an accessory saphenous vein from the back and inner side of the thigh. It has many links with the small saphenous vein and is linked to the deep veins by perforating veins in the leg, near the knee and in the thigh. Just before its end it collects three small superficial veins from the groin and lower abdominal wall: the superficial circumflex iliac, the superficial epigastric and the superficial external pudendal. Its valves direct flow upwards and from superficial to deep.

When the valves fail, the vein becomes varicose, and long-standing venous hypertension may lead to skin changes and ulcers above the ankle. A clot within it, superficial thrombophlebitis, is a concern near the groin or a perforator because it may spread into the deep system. The vein is the classic graft for coronary and peripheral artery bypass, and at the ankle it can be cut down on for emergency fluid access. The saphenous nerve beside it can be damaged during these procedures.

Course and drainage

Begins at

Begins at the medial end of the foot's dorsal venous arch, where it meets the dorsal digital vein of the great toe and the medial marginal vein.

Drains into

Passes through the saphenous opening and ends in the femoral vein at the saphenofemoral junction in the femoral triangle.

Drains

Drains the skin and superficial tissues of the medial foot, leg and thigh and the lower abdominal wall, and through its perforators passes blood into the deep veins.