At which site can the great saphenous vein (GSV) be accessed?

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Last updated: February 13, 2025View editorial policy

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From the Guidelines

The great saphenous vein (GSV) can be accessed at the level of the saphenofemoral junction, knee, or ankle.

Access Sites for Great Saphenous Vein

  • The saphenofemoral junction is a common site for accessing the GSV, particularly for surgical removal or ligation of the vein 1.
  • The knee or ankle level can also be used to access the GSV, depending on the specific procedure or treatment being performed 1.

Clinical Considerations

  • The choice of access site may depend on the individual patient's anatomy and the specific treatment being performed, such as vein ablation or surgical removal of the GSV 1.
  • Preoperative assessment of the GSV, including vein mapping using duplex ultrasound, can help determine the best access site and treatment approach 1.

From the Research

Access Sites for the Great Saphenous Vein

The great saphenous vein (GSV) can be accessed at various sites, including:

  • The proximal thigh, as described in a study published in 2009 2, where the GSV can be exposed via a surgical incision for the insertion of central venous catheters.
  • The thigh level, as reported in a study from 2014 3, where the greater saphenous vein can be used for the placement of peripherally inserted central catheters in children.
  • The ankle level, also mentioned in the 2014 study 3, where the greater saphenous vein can be accessed using anatomical landmarks.
  • The medial distal thigh, as discussed in a 2022 study 4, where the great saphenous vein can provide an alternative site for ultrasound-guided cannulation in cases of difficult peripheral venous access.
  • The saphenofemoral junction, which is the termination point of the GSV into the femoral vein, as studied in a 2024 cadaveric study 5.

Anatomical Considerations

It is essential to consider the anatomical variations of the GSV, such as duplication and persistence of accessory veins, as well as the presence of tributaries, when accessing the vein 6, 5. These variations can affect the success of the procedure and the risk of complications.

Clinical Applications

The GSV can be used for various clinical applications, including:

  • Central venous access for haemodialysis 2
  • Placement of peripherally inserted central catheters in children 3
  • Ultrasound-guided peripheral intravenous cannulation in cases of difficult access 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The great saphenous vein for central venous access and haemodialysis.

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2009

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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