Review Question - QID 100587

The great saphenous vein is the longest vein in the body and runs along the length of the leg. It can be found traveling up the medial side of the thigh.

The great saphenous vein originates at the medial aspect of the foot, courses anterior to the medial maleolus and travels up the medial side of the leg and thigh to just inferior to the pubic tubercle. There it joins with the femoral vein in the region of the femoral triangle. The great saphenous vein can be harvested for used in coronary artery bypass as well as a peripheral arterial bypass. The two methods of harvesting the vein include a long open incision from the groin to ankle as well as a minimally invasive endoscopic approach.

Collins et al. discuss the role of the saphenous vein in the treatment of venous insufficiency. Ablation of the saphenous vein can be used to reduce venous reflux, hasten healing, and prevent ulcer recurrence in individuals with ulcers due to venous insufficiency.

Julliard et al. retrospectively reviewed the outcomes of all lower extremity bypasses (LEBPs) using saphenous vein at a single institution over 8.5 years to assess short term wound infection rates and long-term patency of endoscopic saphenous vein harvest (EVH) verse conventional, open harvest. Their results illustrated an inferior long-term patency rate for EVH after LEBP.

Illustration A depicts the venous anatomy of the lower extremity. Illustration B depicts the pathology of varicose veins, i.e. venous insufficiency of superficial veins.

Incorrect Answers:
Answers 1-3: The great saphenous vein does not course through these locations.
Answer 5: The great saphenous vein terminates deep in the femoral triangle where it joins with the femoral vein. The depth of the vein at this point and proximity to other vascular structures precludes harvesting.