CASE REPORT Corresponding Author: Babak Kazemi Department of Cardiology, Madani Heart Center, Tabriz University of Medical Sciences, Tabriz, Iran. Tel/Fax: +98 411 3344021, E-mail: bkazemia1966@gmail.com Idiopathic Great Saphenous Phlebosclerosis Ahmadreza Jodati, Babak Kazemi, Naser Safaei, and Behrooz Shokoohi Madani Cardiovascular Medical and Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Received: 20 Apr. 2012; Received in revised form: 12 Oct. 2012; Accepted: 5 Jan. 2013 Abstract- Arterial sclerosis has been extensively described but reports on venous sclerosis are very sparse. Phlebosclerosis refers to the thickening and hardening of the venous wall. Despite its morphological similarities with arteriosclerosis and potential morbid consequences, phlebosclerosis has gained only little attention. We report a 72 year old male with paralysis and atrophy of the right leg due to childhood poliomyelitis who was referred for coronary artery bypass surgery. The great saphenous vein, harvested from the left leg, showed a hardened cord-like obliterated vein. Surprisingly, harvested veins from the atrophic limb were normal and successfully used for grafting. © 2013 Tehran University of Medical Sciences. All rights reserved. Acta Medica Iranica, 2013; 51(6): 425-426. Keywords: Coronary bypass; Phlebosclerosis; Saphenous vein Introduction Vascular grafts have been extensively used for many years for revascularization of ischemic cardiac muscle. The great saphenous vein (GSV) and the left internal thoracic artery are widely used as grafts to bypass stenotic or occluded coronary arteries. Despite the increased use of arterial grafts, due to their better long- term patency, the GSV remains the most commonly used conduit for coronary artery bypass grafting (CABG). The short and long term complications and morphological changes of these grafts in the post- operative period are well documented (1,2). Phlebosclerosis of GSVs appears to be exceptional thus warranting the presentation of this case with a review of the literature. Case Report A 72-year old diabetic and hypertensive man with recent unstable angina pectoris was referred to our center for CABG. He had quitted cigarette smoking for the last 20 years. General physical examination showed a paralytic and atrophic right lower limb due to childhood poliomyelitis (Figure 1). Figure 1. (A) Dissected cord-like and obliterated vein. (B) Atrophied right leg. (C) Photograph from light microscopy reveals near complete obliteration of venous lumina by dense fibrous tissue and presence of large areas of calcification, foci of neovascularization, and scattered mononuclear inflammatory cells. The wall shows extensive fibrosis with loss of muscle and marked thickening of the intima (Haematoxylin & Eosin stain; ×100).