26 ORIGINAL ReseARch A. Bendelic et al. Moldovan Medical Journal. September 2020;63(3):26-31 Introduction Te venous anatomy of the lower extremity is substan- tially more variable and complicated than the correspond- ing arterial anatomy. Te lower limb venous system includes superfcial, deep, and perforating veins. Te two major su- perfcial veins of the lower limb, the great and small saphe- nous veins, are located above the deep or muscular fascia, within the subcutaneous tissue. Te deep veins lie beneath the muscular fascia and accompany all major arteries. Te perforating veins penetrate the muscular fascia and connect the superfcial and deep veins [1-4]. A series of bicuspid valves together with venous muscle pumps ensure the re- turn of blood against gravity to the heart. [5]. Te vena saphena magna or great saphenous vein (GSV), the longest vein in the body, arises from the medial aspects of the dorsal pedal venous arch and empties into the femo- ral vein just below the inguinal ligament. During its course, it ascends anterior to the medial malleolus and along the medial border of the tibia, then it passes posterior to the medial condyle of the femur, and further it travels along the medial aspect of the thigh. In the proximal segment of the femoral trigon, the GSV pierces the fascia cribrosa, trans- verses the saphenous opening of the fascia lata and drains into the femoral vein forming the saphenofemoral junction [1-3]. Te GSV lies in the saphenous compartment that is DOI: 10.5281/zenodo.3958531 UDC: 611.147.33 Vena saphena magna – peculiarities of origin, trajectory and drainage * Anastasia Bendelic, Ilia Catereniuc Department of Anatomy and Clinical Anatomy Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, the Republic of Moldova Authors’ ORCID iDs, academic degrees and contributions are available at the end of the article *Corresponding author: anastasia.bendelic@usmf.md Manuscript received July 25, 2020; revised manuscript August 14, 2020; published online August 26, 2020 Abstract Background: Vena saphena magna (VSM) – one of the two superficial venous collectors of the lower limb, the longest vein of the human body, is often accompanied by parallel veins, of which clinical significance may be different. The objective of the study was to investigate the individual anatomical variability of the VSM, on macroscopic aspect, in cadavers, of which variability is important for the vascular surgeon and / or for the cardiac surgeon. Material and methods: This study was conducted on 22 formolized lower limbs using classical dissection methods. The observed anatomical variants were recorded and photographed. Results: The dorsal venous arch of the foot, the origin of the VSM, was double in 2 cases (9.1%), and it was absent in one case (4.55%), thus two dorsal metatarsal veins continued proximally with two medial marginal veins. In the leg, VSM was double in one case (4.55%), and in other 14 cases (63.63%) it was accompanied by accessory saphenous veins. In the thigh, it was double in 3 cases (13.6%), and in 10 cases (45.5%) it was accompanied by accessory saphenous veins. The saphenofemoral junction was located at 4.23±0.64 cm distance from the pubic tubercle; at 12.25±1.1 cm away from the anterior superior iliac spine and at 4.3±0.65 cm below the middle of the inguinal ligament. Conclusions. The anatomical variability of the VSM includes its duplicity and/or presence of the accessory saphenous veins. The dorsal venous arch may be double or absent. The saphenofemoral junction is relatively fixed in relation to the neighboring bone landmarks. Key words: great saphenous vein, accessory saphenous veins. Cite this article Bendelic A, Catereniuc I. Vena saphena magna – peculiarities of origin, trajectory and drainage. Mold Med J. 2020;63(3):26-31. doi: 10.5281/zenodo.3958531. bordered superfcially by saphenous fascia and deeply by the muscular fascia, but its tributaries are external to the com- partment [6, 7]. Te GSV remains an essential component in strategies for coronary artery bypass grafing in humans. Te vessel is used alone or in combination with arterial grafs and has the advantage of being available autologous vascular tissue in most patients in need of such surgeries [5]. Te clinical usage of the GSV has made its anatomical variations note- worthy. Te GSV is ofen accompanied by its tributaries and at times tributaries can be confused with the GSV or be mis- taken for GSV duplication. Accessory saphenous veins, trib- utaries of the great saphenous vein, also may be important in the pathophysiology of the chronic venous disease. Tere are two main saphenous tributaries in the calf, the anterior (or anterior arch vein) and the posterior (or posterior arch (Leonardo`s) vein) accessory great saphenous veins, that join the GSV just distal to the knee [8, 9]. Te clinically im- portant posterior tibial perforating veins (Cockett perfora- tors) join the posterior arch vein rather than the main trunk of the GSV [3]. In the thigh, the anterior and posterior ac- cessory great saphenous veins ascend parallel to the GSV, external to the saphenous fascia [8, 9]. Te venous drainage from the perineum and lower abdominal wall (superfcial