Saphenous Vein

Like all the other veins in the body, the Great Saphenous Vein’s (GSV) function is to return venous blood to your heart. The oxygen and nutrients contained in your arterial blood are vital to the many living tissues in your body. This is a large and superficial vein in the lower limb. Originating from the dorsal vein of the hallux, it merges with the dorsal venous arch in your foot.

The Great Saphenous Vein connects with smaller veins from your ankle and foot. Included in this connection are the medial marginal vein and the small saphenous vein. The medial marginal vein drains the sole of your foot, while the small saphenous vein has many connections with its small counterpart in the lower region of your leg. Closer to your knee the Great Saphenous Vein connects with three tributaries: posteromedial, anterolateral and peri-inguinal.

Overview:

The living tissues in your body have to work to metabolize the nutrients and oxygen they receive. In this process, carbon dioxide, urea, water and other waste products are produced. The healthy tissue in the body needs these waste products removed so they can function properly. The venous blood then moves these waste products to your lungs where the carbon dioxide that was created gets breathed out. The venous blood also moves carbon dioxide to your kidneys so that the urea can remove them from your body.

What is the function of the Saphenous Vein?

The Great Saphenous Vein (GSV) serves as the main truncal vein of the lower leg. Being so, it drains blood coming from the inner part of your foot, front and inner sides of the lower leg and from the inner part of your thigh. There is a small saphenous vein (SSV) and it drains venous blood from the outside of your foot and the back and outer sides of the lower leg. Differing from the great saphenous vein, it does not drain any venous blood from the thigh because it is connected to popliteal vein.

Venous blood drained from the skin and fat from the front and outside of your thigh is done so by the Anterior Accessory Saphenous Vein (AASV). This vein connects with the Great Saphenous Vein in the groin and posterior regions of the thigh, and is drained by the Posterior Accessory Saphenous Vein (PASV), which drains into the Great Saphenous Vein (GSV). The bloodstreams send blood to the Great Saphenous Vein (GSV) and from here it gets sent up and into the groin’s deep system.

Possible complications that can occur with the Saphenous Vein

Two major issues that can happen with the superficial veins in your legs are:

1. Thrombosis caused by blood clotting
2. Failure of blood valves which causes blood to “reflux” in the opposite direction of normal blood flow, resulting in venous inefficiencies

Deep vein thrombosis (DVT) is an ailment that occurs when a blood clot develops in one or many of the deep veins in your legs. This clotting causes pain in your legs, swelling, but in some cases, there are no symptoms at all. Certain medical conditions can cause deep vein thrombosis. Some of these medical conditions include:

  • Age
  • Inheriting blood clot disorders
  • Extended bed rest
  • Heart failure
  • Injury or surgery
  • Pregnancy
  • Being overweight or obese
  • Bowel diseases (Crohn’s or ulcerative colitis)
  • Sitting for extended periods of time

This can be a very serious condition, culminating in a pulmonary embolism. A pulmonary embolism is when blood clots break loose in your veins, become lodged in your lungs and block blood flow. Some warning signs of a pulmonary embolism are:

  • Coughing up blood
  • Chest pain
  • Discomfort when breathing deeply or coughing
  • Lightheadedness
  • Fainting
  • Rapid pulse
  • Quick onset of shortness of breath

When valves fail in the Great Saphenous Vein (GSV), this results in venous reflux or venous inefficiencies. These issues inhibit the veins from functioning normally. The valves in the legs prohibit blood from flowing in the wrong direction because of gravity when you are standing or walking. This condition can be inherited from family members. This issue is serious to begin with, but more so in the Great Saphenous Vein (GSV). This is the longest vein in the leg and there are no other valves in it. Because of this, if the one valve fails, when a person stands, blood can travel directly from their heart down to their ankle.

This results in varicose veins or it causes inflammation and damage to the leg’s capillaries which creates the following issues:

  • Swelling in the legs
  • Tenderness/tiredness in the ankles
  • Venous eczema
  • Red or brown patches on the ankles
  • Venous leg ulcers

Treating the Great Saphenous Vein (GSV)

When a complication occurs in this vein, treatment is catered to the specific condition you have at the time. In treating superficial thrombophlebitis, it is done in two ways. The first priority is limiting the amount of pain you are experiencing from the inflammation caused by phlebitis. Additionally, support is given to the leg to prevent nearby veins from being affected by thrombosis. The common form of treatment is a prescription of anti-inflammatory, non-steroidal tablets like aspirin.

Another available treatment method is the use of graduated pressure support stockings. These stocking ensure blood continues flowing up your veins as normal, to reduce increased occurrences of thrombophlebitis in the vein currently affected by it, or new occurrences in other veins. The initial treatment of superficial thrombophlebitis does not involve the use of antibiotics. Even though the symptoms are the area feeling red, painful, swollen and hot, this is because of the blood clot, not an infection as you might think.

The common treatment of venous reflux (venous incompetence) of the Great Saphenous Vein (GSV) is with open surgery. Under general anesthesia, an incision is made in the groin and the saphenofemoral junction (SFJ) is tied by a surgical ligation. In the majority of instances, the Great Saphenous Vein (GSV) is then stripped off using a vein stripper. The great saphenous vein could also be stripped out of the leg during the removal of varicose veins as well as being used for grafts during coronary bypass surgery.

In many cases (if not the majority) this traumatic removal of the vein only causes the body to try and re-grow the vein. Because of this, not only does tying and stripping the vein involve unnecessary large scarring, bruising from stripping and an avoidable general anesthesia, but in the medium to long term, it does prove beneficial in many patients. When veins regrow, they do not grow back with valves that work. This results in vein that are always incompetent allowing venous reflux.

Preventing issues with the saphenous vein

To avoid the common complications associated with this vein, avoid doing the following:

Keep yourself moving: Post-surgery, it is easy to think that resting is the best option, which is partially true, but it is best to get moving as soon as possible to keep blood flowing as normal.

Active and healthy lifestyle: Do not smoke, exercise regularly, lose weight and get enough sleep nightly.