Great saphenous vein

The vena saphena magna (VSM) is a truncal vein that runs from the inner ankle on the inside of the leg to the groin. In most cases it runs unitary, more rarely it is doubled in sections. In the groin it flows into the deep leg vein (vena femoralis communis). It runs in the fascia - on the muscular fascia and under the saphenous fascia. In sonography, this results in a double contour, which is called the saphenous eye or Egyptian eye. Veins that lie outside the fascia are by definition not saphenous veins but side branches. The configuration of the fascial compartment (proximally wide, distally narrow) means that the VSM distal rarely has insufficiencies.

On its way, the VSM receives numerous side branches and drains the blood via the Vv. perforantes into the deep leg veins. In about 25% of cases, the VSM may have a so-called accessory superficial accompanying vein (accessorian saphenous vein).

At the junction with the femoralis communis vein in the groin (cross), the VSM receives various side branches. They can all enter the VSM individually or they can flow together first and then enter the VSM. The terminal valve is almost always found in the orifice of the magna saphenous vein. A pre-terminal valve lies distal to the junction of the lateral branches. If both valves are sufficient, there is no reflux in the orifice of the VSM.

1. Mendoza E et al.(2016) Duplex anatomy of the superficial leg veins. Vasomed 28: 32-38
2. Reich-Schupke S (2015) Anatomy of the venous system of the legs. In: Endovenous procedures. Schattauer-Verlag. Stuttgart. S. 1-36