Feb 11, 2026

Public workspaceAnatomic description of the distal great saphenous vein-a cadaveric study with clinical correlation

DOI
https://dx.doi.org/10.17504/protocols.io.j8nlk16qxg5r/v1
  • Latha Prabhu1,
  • Mamatha Tonse1,
  • BV Murlimanju2
  • 1Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India;
  • 2Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
BV Murlimanju
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DOI: https://dx.doi.org/10.17504/protocols.io.j8nlk16qxg5r/v1
Protocol Citation: Latha Prabhu, Mamatha Tonse, BV Murlimanju 2026. Anatomic description of the distal great saphenous vein-a cadaveric study with clinical correlation. protocols.io https://dx.doi.org/10.17504/protocols.io.j8nlk16qxg5r/v1
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License,  which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: February 10, 2026
Last Modified: February 11, 2026
Protocol Integer ID: 242997
Keywords: Great saphenous vein, Saphenous opening, Saphenous nerve, Saphenofemoral junction, Venous cut down , exact location of great saphenous vein, great saphenous vein, relationship of the saphenous nerve, saphenous nerve, surgeries of varicose vein, varicose vein, vein, cadaveric study, cadaveric study with clinical correlation, anatomic description, medial malleolus
Abstract
This study is useful in stripping surgeries of varicose veins to know the accurate location of the perforators, the relationship of the saphenous nerve to the great saphenous vein, to find out exact location of great saphenous vein in relations to the landmark, medial malleolus in precise in case of venesection or a canalization in acute emergency.
Attachments
Icon for GSV_Protocol.pdf
GSV_Protocol.pdf
367KB
Guidelines
This protocol is already approved by the Ethics Committee of Kasturba Medical College, Mangalore, India, Reg. No. ECR/541/IND/KA/2014/RR-20

The approval number IEC KMC MLR 09/2024/568, dated 19/09/2024
Materials
Digital Vernier Caliper (Mitutoyo, Japan)
Troubleshooting
1. Introduction
The great saphenous vein is the longest vein in the body, which originates as a continuation of the medial marginal vein in the medial aspect of the dorsal venous arch of the foot [1]. It ascends anterior to the medial malleolus obliquely in the medial aspect of the leg and thigh and ends by draining into the femoral vein at the saphenofemoral junction after piercing the cribriform fascia [2]. Getting vascular access is of paramount importance for the resuscitation of an acutely ill patient [3]. Even though the upper limb veins are targeted first in gaining venous access, the distal great saphenous vein becomes a popular site in hemodynamically unstable patients with visually indiscernible veins, especially in a resource-poor setting [3]. Vascular access to the distal great saphenous vein can be achieved by percutaneous venous cannulation and distal saphenous venous cut-down, while the constant location of the vessel, its large caliber, having located on tough periosteum and thick wall of the vein facilitate these procedures [4].
The establishment of venous access is essential to the treatment and resuscitation of both the medically and traumatically ill patient. Adequate venous access allows the delivery of fluids, blood products, medications, and repeated blood sampling. [5]
The venous cutdown technique is a surgical procedure to gain venous access when relatively less invasive percutaneous procedures such as the Seldinger technique (percutaneous access), ultrasound-guided venous access, and intraosseous vascular access have failed. Percutaneous access can be difficult to achieve in certain patient populations (pediatric patients with small and nonpalpable veins, patients in hypovolemic shock with collapsed veins, patients with peripheral vascular disease with altered vascular anatomy) making venous cutdown a life-saving alternative.[6][7][8]
Venous disease is the most common cause of leg ulceration, and compression therapy improves venous ulcer healing. (9,10) Superficial venous reflux (varicose veins) is usually present in patients with venous leg ulcers. (11)
Knowledge gap identified: The studies are scarce regarding the morphology of great saphenous vein as this is essential for the clinical practice. The implications include accurate canulation of GSV, the saphenous nerve involvement during stripping surgery, the role of both GSV and SN in ulcer formation at medial malleolus and on dorsum of foot, ligation of perforators at ankle, summons more anatomical studies in this region.
Protocol references
1. Chen SSH, Prasad SK. Long saphenous vein and its anatomical variations. Australasian Journal of Ultrasound in Medicine. 2009;12:28–31. doi: 10.1002/j.2205-0140.2009.tb00004.x.
2. De Maeseneer M, Philipsen T, Vandenbroeck C, Lauwers P, Hendriks J, De Hert S, Van Schil P. Closure of the cribriform fascia: an efficient anatomical barrier against postoperative neovascularisation at the saphenofemoral junction? A prospective study. Eur J Vasc Endovasc Surg. 2007;34:361–366. doi: 10.1016/j.ejvs.2007.03.020.
3. Lee MM, Anand S, Loyd JW. Saphenous vein cutdown. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. https://pubmed.ncbi.nlm.nih.gov/30422475/.
4. Posner MC, Moore EE. Distal greater saphenous vein cutdown—technique of choice for rapid volume resuscitation. J Emerg Med. 1985;3:395–399. doi: 10.1016/0736-4679(85)90324-5.
5.Ker K, Tansley G, Beecher D, Perner A, Shakur H, Harris T, Roberts I. Comparison of routes for achieving parenteral access with a focus on the management of patients with Ebola virus disease. Cochrane Database Syst Rev. 2015 Feb 26;2015(2):CD011386.
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11.Adam DJ, Naik J, Hartshorne T, Bello M, London NJ. The diagnosis and management of 689 chronic leg ulcers in a single-visit assessment clinic. Eur J Vasc Endovasc Surg 2003;25:462-468.
12.Senevirathne SAMDRU, Nimana HKV, Pirannavan R, Fernando P, Salvin KA, Liyanage UA, Malalasekera AP, Mathangasinghe Y, Anthony DJ. Anatomic description of the distal great saphenous vein to facilitate peripheral venous access during resuscitation: a cadaveric study. Patient Saf Surg. 2023 Jan 23;17(1):2. doi: 10.1186/s13037-023-00351-2.
13. Human P, Franz T, Scherman J, Moodley L, Zilla P. Dimensional analysis of human saphenous vein grafts: implications for external mesh support. J Thorac Cardiovasc Surg. 2009;137:1101–1108. doi: 10.1016/j.jtcvs.2008.10.040.
14. Hamel-Desnos CM, De Maeseneer M, Josnin M, Gillet J-L, Allaert F-A, Lausecker M, Chauzat B, Gérard J-L, Daniel C, Tripey V. Great saphenous vein diameters in phlebological practice in France: a report of the DIAGRAVES Study by the French Society of Phlebology. Eur J Vasc Endovasc Surg. 2019;58:96–103. doi: 10.1016/j.ejvs.2018.09.011.
15. Meshram SW, Ganorkar Y, Rukhmode V, Golghate T. Study of Variation of Great Saphenous Veins and Its Surgical Significance (Original Study) J Dent Med Sci. 2018;17:21–26
16. Ker K, Tansley G, Beecher D, Perner A, Shakur H, Harris T, Roberts I. Comparison of routes for achieving parenteral access with a focus on the management of patients with Ebola virus disease. Cochrane Database Syst Rev. 2015;2:CD011386.
17Holme JB, Holme K, Sørensen LS. The anatomic relationship between the long saphenous vein and the saphenous nerve. Relevance for radical varicose vein surgery. Acta Chir Scand. 1988 Nov-Dec;154(11-12):631-3. PMID: 3232480
18.Ramasastry SS, Dick GO, Futrell JW. Anatomy of the saphenous nerve: relevance to saphenous vein stripping. Am Surg. 1987 May;53(5):274-7. PMID: 2953287
Acknowledgements
All the authors of this manuscript sincerely thank the body donors; it was only because of their contribution this anatomical research by the cadavers could be performed. The body and their families are very much respected among our scientific community.