Clinically relevant topography of the great saphenous vein and saphenofemoral junction, a study from adult embalmed cadavers

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Murlimanju" }, { "@type": "Person", "name": "M. Praveen Shenoy" }, { "@type": "Person", "name": "Mangala M Pai" }, { "@type": "Person", "name": "Mamatha Tonse" }, { "@type": "Person", "name": "Ashwin R Rai" } ], "publisher": { "@type": "Organization", "name": "F1000Research", "logo": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 480, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 1200, "width": 150 }, "description": " Background Knowledge of the morphology of the great saphenous vein (GSV) is important because of its clinical applications and involvement in venous diseases. In this study, the aim was to determine the morphology and topography of the saphenous opening and to perform side-based and gender-based comparisons. The objective of this study was to describe the precise topography of the GSV with respect to the medial malleolus and saphenous nerves. Methods This is an institution-based cross-sectional study including 40 lower extremities from 20 adult embalmed cadavers. The morphometric data was obtained by applying a digital Vernier caliper. Results The shape of the saphenous opening was noted. In 29 extremities (72.5%), the saphenous opening was vertically oval, with a round shape in 8 (20%) and a kidney shape in 3 (7.5%). There was no statistically significant difference (p>0.05) between the right- and left-sided morphometric data. The present study observed that females had smaller dimensions of the saphenous opening and it was more supero-medially placed than in males (p<0.05) in relation to the pubic tubercle. In 24 lower extremities (60%), the saphenous nerve ran anterior to the GSV, and in the remaining 16 (40%), the saphenous nerve was divided into two branches running anterior and posterior to the GSV between the knee and ankle joints. Conclusion The present study provides important data on the morphology and topography of the saphenous opening and GSV in relation to the pubic tubercle, medial malleolus, and saphenous nerve. However, the data would be more accurate with a larger sample size. 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F1000Research 2026, 15 :349 ( https://doi.org/10.12688/f1000research.178143.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Clinically relevant topography of the great saphenous vein and saphenofemoral junction, a study from adult embalmed cadavers [version 1; peer review: 1 approved with reservations, 1 not approved] Latha V Prabhu 1 , B.V. Murlimanju https://orcid.org/0000-0003-1248-8296 1 , M. Praveen Shenoy 1 , Mangala M Pai https://orcid.org/0000-0001-6995-5807 1 , Mamatha Tonse https://orcid.org/0000-0003-1322-6730 1 , Ashwin R Rai https://orcid.org/0000-0001-8574-1809 1 Latha V Prabhu 1 , B.V. Murlimanju https://orcid.org/0000-0003-1248-8296 1 , [...] M. Praveen Shenoy 1 , Mangala M Pai https://orcid.org/0000-0001-6995-5807 1 , Mamatha Tonse https://orcid.org/0000-0003-1322-6730 1 , Ashwin R Rai https://orcid.org/0000-0001-8574-1809 1 PUBLISHED 04 Mar 2026 Author details Author details 1 Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India Latha V Prabhu Roles: Conceptualization, Data Curation, Investigation, Methodology B.V. Murlimanju Roles: Investigation, Validation, Writing – Original Draft Preparation M. Praveen Shenoy Roles: Data Curation, Investigation, Methodology Mangala M Pai Roles: Writing – Review & Editing Mamatha Tonse Roles: Conceptualization, Data Curation, Investigation, Methodology Ashwin R Rai Roles: Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Manipal Academy of Higher Education gateway. Abstract Background Knowledge of the morphology of the great saphenous vein (GSV) is important because of its clinical applications and involvement in venous diseases. In this study, the aim was to determine the morphology and topography of the saphenous opening and to perform side-based and gender-based comparisons. The objective of this study was to describe the precise topography of the GSV with respect to the medial malleolus and saphenous nerves. Methods This is an institution-based cross-sectional study including 40 lower extremities from 20 adult embalmed cadavers. The morphometric data was obtained by applying a digital Vernier caliper. Results The shape of the saphenous opening was noted. In 29 extremities (72.5%), the saphenous opening was vertically oval, with a round shape in 8 (20%) and a kidney shape in 3 (7.5%). There was no statistically significant difference (p>0.05) between the right- and left-sided morphometric data. The present study observed that females had smaller dimensions of the saphenous opening and it was more supero-medially placed than in males (p<0.05) in relation to the pubic tubercle. In 24 lower extremities (60%), the saphenous nerve ran anterior to the GSV, and in the remaining 16 (40%), the saphenous nerve was divided into two branches running anterior and posterior to the GSV between the knee and ankle joints. Conclusion The present study provides important data on the morphology and topography of the saphenous opening and GSV in relation to the pubic tubercle, medial malleolus, and saphenous nerve. However, the data would be more accurate with a larger sample size. READ ALL READ LESS Keywords Great saphenous vein, Saphenous opening, Saphenous nerve, Saphenofemoral junction, Venous cut down Corresponding Author(s) Mamatha Tonse ( [email protected] ) Close Corresponding author: Mamatha Tonse Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2026 V Prabhu L et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: V Prabhu L, Murlimanju BV, Shenoy MP et al. Clinically relevant topography of the great saphenous vein and saphenofemoral junction, a study from adult embalmed cadavers [version 1; peer review: 1 approved with reservations, 1 not approved] . F1000Research 2026, 15 :349 ( https://doi.org/10.12688/f1000research.178143.1 ) First published: 04 Mar 2026, 15 :349 ( https://doi.org/10.12688/f1000research.178143.1 ) Latest published: 11 May 2026, 15 :349 ( https://doi.org/10.12688/f1000research.178143.2 )  There is a newer version of this article available. Suppress this message for one day. Introduction The great saphenous vein (GSV) drains into the femoral vein at the saphenofemoral junction (SFJ). The valves in the SFJ maintain the unidirectional flow of blood, preventing backflow and venous insufficiency. 1 – 3 Knowledge of SFJ's anatomy of the SFJ is crucial for treating venous diseases and successful postoperative outcomes. 4 , 5 It has been described that the SFJ can have significant anatomical variations, the prior knowledge of which is crucial to prevent iatrogenic injuries and to plan the surgery. Radiological investigations have revealed that the SFJ region is more complex than that previously described. Hence, accurate identification of the detailed anatomy and knowledge of anatomical variations are necessary while addressing varicose veins. 6 It has been reported that inadequate identification of the topography of the GSV and misinterpretation of the SFJ can lead to varicose veins. 7 , 8 The distal part of the GSV is often utilized for venous access during procedures such as percutaneous cannulation or venous cutdown and strip of varicosities, where iatrogenic injury to the saphenous nerve should not occur. A literature review revealed that studies regarding the morphology of the GSV are scarce, particularly from our sample population with respect to its relation to the saphenous nerve (SN) and SFJ. The morphology and topography of the GSV have clinical implications, including accurate canulation, involvement of the saphenous nerve during stripping surgery, involvement of the GSV and SN in ulcer formation at the medial malleolus and on the dorsum of the foot, and ligation of perforators at the ankle, which summons more anatomical studies in this region. These are the rationale for performing this anatomical research, and the goal of this anatomical study was to record the morphology and topography of the saphenous opening and to perform side- and gender-based comparisons of the variability. The objective of this study was to investigate the topography of the distal GSV with respect to the medial malleolus and the SN. Methods This institutionally based cross-sectional anatomical study performed between 2024 and 2025 included 40 adult lower extremities from 20 adult embalmed cadavers. Of these, ten were male and female cadavers. The ethnicity of the population studied belonged to Dravidian descent. Only adult embalmed cadavers from the South Indian population were included, and the lower extremities with any obvious visible pathology were excluded. A convenient sampling method was considered, that is, the number of specimens available in our department. The Institutional Ethics Committee of Kasturba Medical College, Mangalore, India Reg. No. ECR/541/IND/KA/2014/RR-20 (IEC KMC MLR 09/2024/568, dated 19/09/2024) was approved and permitted for this study. The cadavers utilized in this study belonged to the department of anatomy of our institution. These adult cadavers were from donated bodies and the written informed consent for the utilization of them for the purpose of medical teaching and medical research was obtained during the time of donating the body. The protocol of this study was archived in dx.doi.org/10.17504/protocols.io.j8nlk16qxg5r/v1 . Different shapes of the saphenous openings were identified. A digital vernier caliper (Mitutoyo, Japan) was used to perform the measurements in this study, which included the vertical length and width of the saphenous opening, and the vertical (ab in Figure 1 ), lateral (bc in Figure 1 ), and oblique (ac in Figure 1 ) distances of the SFJ from the pubic tubercle. A vertical plane was drawn from the saphenous opening, and a horizontal plane was drawn from the pubic tubercle. The meeting point of these two lines was used to measure the vertical and lateral distances of the SFJ from the pubic tubercle. The horizontal distance between the GSV and the midpoint of the medial malleolus was determined. The diameter of the GSV was then measured. The relationship between the saphenous nerve and GSV was studied based on the classification by Wilmot and Evans, 5 which is shown in Figure 2 . Figure 1. Schematic diagram showing the topographic details of the saphenofemoral junction (SFJ), which are collected in this study; ab-vertical distance; bc-lateral distance; ac-oblique distance of SFJ from the pubic tubercle (PT); ASIS-anterior superior iliac spine; IL-inguinal ligament; PS-pubic symphysis; GSV-great saphenous vein; FV-femoral vein. Figure 2. Schematic representation of the relation of GSV and saphenous nerve as per Wilmot and Evans classification. Only one author performed all measurements to prevent inter-observer errors. Three measurements were recorded for each dimension, and their average was considered the final measurement to prevent intra-observer bias. SPSS version 29 (IBM, USA) was used for statistical analysis. The paired t-test and independent sample t-test were used for comparisons ( Tables 1 and 2 ). Table 1. Side-based comparison of the morphometric and topographic data of the saphenofemoral junction (SFJ). Parameter measured Right side Left side Vertical length of saphenous opening 3±0.4 cm 2.7±0.4 cm Width of saphenous opening 1.7±0.5 cm 1.5±0.5 cm Lateral distance of SFJ from pubic tubercle 3.8±0.9 cm 3.6±1.3 cm Vertical distance of SFJ from pubic tubercle 1.8±0.8 cm 2.4±1 cm Oblique distance of SFJ from pubic tubercle 4.3±0.7 cm 4.3±1.4 cm Table 2. Gender-based comparison of the morphometric and topographic data of the saphenofemoral junction (SFJ). Parameter measured Male Female Vertical length of saphenous opening 1.7±0.8 cm 1.6±0.1 cm Width of saphenous opening * 0.9±0.4 cm 0.5±0 cm Lateral distance of SFJ from pubic tubercle * 3.7±0.9 cm 3.3±1.3 cm Vertical distance of SFJ from pubic tubercle * 2±0.4 cm 1.4±0.7 cm Oblique distance of SFJ from pubic tubercle * 4.1±0.6 cm 3.6±0.9 cm * statistically significant difference exists (p<0.05). Results In 29 extremities (72.5%), the saphenous opening was vertically oval ( Figure 3A ), round in 8 (20%, Figure 3B ), and kidney in 3 (7.5%, Figure 3C ). A side-based comparison of the measured parameters is presented in Table 1 , and there was no significant difference (p > 0.05). Table 2 presents a sex-based comparison of the measurements. In the present study, females had small saphenous opening dimensions (p < 0.05), and the saphenous opening was more supero-medially placed in females than in males (p < 0.05). Figure 3. Lower limbs of the embalmed cadavers showing the vertically oval shaped saphenous opening (A); round shaped saphenous opening (B) and the kidney shaped saphenous opening (C). In 24 lower extremities (60%), the saphenous nerve ran anteriorly to the GSV (type B, Figure 4B ), and in the remaining 16 (40%), the saphenous nerve was divided into two branches (type A, Figure 4A ) running anteriorly and posteriorly to the GSV between the knee and ankle joints. Type C pattern, as per the Wilmot and Evans classification, 5 was not observed in this study. The distance between GSV and medial malleolus was 2.34 ± 0.75 cm on the right side and 2.29 ± 0.52 cm on the left side. The depth of GSV from the skin was 0.31 ± 0.07 cm and 0.28 ± 0.09 cm on the right and left lower limbs. The diameter of the GSV near the medial malleolus measured 0.41 ± 0.09 cm on the right lower extremity and 0.38 ± 0.05 cm on the left lower extremity. Figure 4. A. A branch of saphenous nerve running anterior to GSV and another branch of it running posterior (type A), observed in 16 lower limbs (40%); B. Saphenous nerve was running anterior to GSV (type B), observed in 24 lower limbs (60%). Discussion The GSV pierces the cribriform fascia at the lower corner of the falciform margin of the saphenous opening and terminates in the femoral vein. The saphenous opening is a defect in the fascia lata of the thigh in the upper part of the femoral triangle. The usual type of saphenous opening is described as ‘vein star’ shape, however as per the study by Ndiaye et al. 9 this shape was present in only 10% cases. However, the literature review did not reveal studies on the different shapes of the saphenous opening. The present study can be considered novel from this perspective, as three different shapes are observed. Vertically oval, round, and kidney-shaped saphenous openings are reported in this study. This knowledge will add to the existing literature as the saphenous opening is a complex structure with significant morphological variability, which is important for clinical procedures involving the GSV. GSV is considered as the longest vein in the human body, which is formed by the joining of the medial marginal vein and the medial end of the dorsal venous arch of the foot, runs superiorly just anterior to the medial malleolus, followed by the medial aspects of the leg and thigh. 10 , 11 In an ultrasound observation, it was reported that the center of the SFJ was found to be at 1 ± 0.9 cm inferiorly and 2.4 ± 0.6 cm laterally from the pubic tubercle. 5 However, it has been reported that this location can vary slightly based on factors such as sex and body composition. The junction was slightly proximal to the pubic tubercle in females in comparison to males. 5 In this anatomical research, it was observed that the SFJ was more supermedially placed in females than in males ( Table 2 ). The present study reports both side- and gender-based data on the topography of the saphenofemoral junction. Statistical significance was determined by comparing the data for the right and left, lower limbs ( Table 1 ). The SFJ can have one to ten tributaries, with a median number of four. 7 , 8 These include the superficial and deep external pudendal veins, superficial epigastric vein, and superficial circumflex iliac vein. 8 The GSV can be bifid in approximately 18.1% of cases, meaning it splits into two trunks at the SFJ. 7 There are few reports that suggest that the external pudendal artery runs in front of the GSV. In the present study, this anatomical variation was not observed, which may be due to the smaller number of samples being studied. The complicated anatomy and morphological variations at the SFJ can lead to significant challenges during surgery, such as the risk of missing tributaries or causing iatrogenic trauma to the surrounding structures. Failure to identify the tributaries and their ligation can lead to recurrence of varicose veins. 8 , 12 Detailed anatomical knowledge allows for better preoperative evaluations, ensuring that patients with anatomical variations receive accurate surgical procedures. 13 Preoperative ultrasound and CT venography can help detect the venous anatomy and its anatomical variations, such as the unusual location of the GSV. 14 , 15 Venous cutdown was performed to gain access to the GSV. There are different types of vascular access, such as percutaneous, ultrasound-guided, and intraosseous. Lack of insight of the surface anatomy and dimensions of GSV can cause difficulty in these procedures and may demand more time consumption for GSV access. 16 It was described that the distal great saphenous vein runs 2.5 cm in front of the medial malleolus, 4 mm deeper to skin and presents a diameter of 4 mm. 17 The GSV was 2.34 ± 0.75 cm and 2.29 ± 0.52 cm anterior to the medial malleolus over the right and left sides in the present study. The depth of GSV from the skin was 0.31 ± 0.07 cm and 0.28 ± 0.09 cm over the right and left sides. The diameter near the medial malleolus was 0.41 ± 0.09 cm on the right and 0.38 ± 0.05 cm on the left lower limbs of this study. The limitations of these data include embalming, which may have altered their dimensions. However, the data are comparable to the previous clinical study of saphenous venous grafts for cardiothoracic surgery, where it was 0.42 cm in diameter. 18 In the present study, 60% of lower extremities had the saphenous nerve running anterior to the GSV which is type ‘B’ of Wilmot and Evans classification and in the remaining 40%, the saphenous nerve divided into two branches (type A) and running anterior and posterior to GSV, between the knee and ankle joints. The type C pattern of the Wilmot and Evans classification, 5 where branching of the saphenous nerve occurs in the thigh region, was not observed in the present anatomical study. Sensory disturbances in the saphenous nerve distribution after the stripping procedure of GSV have been reported in clinical literature. In clinical research, the GSV was stripped upward in one leg and downwards in the other, and the comparison was performed. It was finally opined that the stripping of GSV upwards could lead to a significant sensory deficit than inferiorly. 19 It is overall suggested that stripping of the distal part of the GSV could be avoided to reduce the risk of damage to the saphenous nerve. 20 In this context, the morphological and topographic data obtained from this study may be of clinical importance and can assist the operating surgeon with better outcomes. The data may be considered a morphological database of our sample population. However, the present study has certain limitations like the samples are formalin fixed cadavers, which might have alteration in the dimension because of the embalming. Another limitation of this study is the small sample size, and the data may be more accurate with a larger sample size. Conclusion A detailed understanding of SFJ morphology and topography is vital for clinicians to perform successful interventions and effectively manage venous disorders. It is essential to understand the relationship between the GSV and the saphenous nerve, GSV, and bony landmarks, such as the medial malleolus. In this context, anatomical details obtained from this study can be useful in procedures such as stripping surgeries of the GSV, thermal ablation of varicosities, venesection, and canalization in acute emergencies. Ethical statement The authors state that every effort was made to follow the institutional and international ethical guidelines and laws pertaining to medical research. Data availability Underlying data repository name: [Morphometry of saphenofemoral junction] https://doi.org/10.6084/m9.figshare.31306825 . 21 The project contains the following underlying data: [Saphenous vein topography] (Raw Data). Data is available under the terms of the Creative Commons By 4.0 License (CC-BY 4.0). Acknowledgements All the authors of this manuscript sincerely thank the body donors for their contribution to this anatomical research by the cadavers. The body and its families are respected by the scientific community. References 1. Cappelli M, Molino Lova R, Ermini S, et al. : Hemodynamics of the sapheno-femoral complex: an operational diagnosis of proximal femoral valve function. Int. Angiol. 2006; 25 (4): 356–360. PubMed Abstract 2. Lurie F, Kistner RL: The relative position of paired valves at venous junctions suggests their role in modulating three-dimensional flow pattern in veins. Eur. J. Vasc. Endovasc. Surg. 2012; 44 (3): 337–340. PubMed Abstract | Publisher Full Text 3. Stücker M, Moritz R, Altmeyer P, et al. : New concept: different types of insufficiency of the saphenofemoral junction identified by duplex as a chance for a more differentiated therapy of the great saphenous vein. Phlebology. 2013; 28 (5): 268–274. PubMed Abstract | Publisher Full Text 4. Koca F, Levent F, Tatlı AB, et al. : The impact of invasive treatment of superficial venous insufficiency of the lower extremities on cardiac functions. Phlebology. 2023; 38 (8): 561–569. PubMed Abstract | Publisher Full Text 5. Mirjalili SA, Muirhead JC, Stringer MD: Redefining the surface anatomy of the saphenofemoral junction in vivo. Clin. Anat. 2014; 27 (6): 915–919. PubMed Abstract | Publisher Full Text 6. Ríos J: The anatomy and physiology of the saphenofemoral junction: the complexity of a venous structure that every phlebologist should be familiar with. Acta. Phlebologica. 2023; 24 : 96–101. Publisher Full Text 7. Donnelly M, Tierney S, Feeley TM: Anatomical variation at the saphenofemoral junction. Br. J. Surg. 2005; 92 (3): 322–325. PubMed Abstract | Publisher Full Text 8. Souroullas P, Barnes R, Smith G, et al. : The classic saphenofemoral junction and its anatomical variations. Phlebology. 2017; 32 (3): 172–178. PubMed Abstract | Publisher Full Text 9. Ndiaye A, Ndiaye A, Ndoye JM, et al. : The arch of the great saphenous vein: anatomical bases for failures and recurrences after surgical treatment of varices in the pelvic limb. About 54 dissections. Surg. Radiol. Anat. 2006; 28 (1): 18–24. PubMed Abstract | Publisher Full Text 10. Chen SS, Prasad SK: Long saphenous vein and its anatomical variations. Australas. J. Ultrasound Med. 2009; 12 : 28–31. PubMed Abstract | Publisher Full Text | Free Full Text 11. De Maeseneer MG, Philipsen TE, Vandenbroeck CP, et al. : 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 (3): 361–366. PubMed Abstract | Publisher Full Text 12. Brenner E: Saphenofemoral recurrence from an an anatomist’s point of view. Phlebologie. 2020; 49 (3): 133–138. Publisher Full Text 13. Vogt K, Gillner J, Bader C, et al. : Postoperative Komplikationen nach inguinaler Re-Krossektomie [Postoperative complications after recrossectomy of the saphenofemoral junction]. Zentralbl. Chir. 2012; 137 (5): 478–484. PubMed Abstract | Publisher Full Text 14. Orsini A, Allegra C, Alessandro D, et al. : Anatomical variations of the superficial internal epigastric vein compared with the saphenofemoral junction: a preliminary study. Acta. Phlebol. 2015; 16 (3): 103–106. 15. Kim R, Lee W, Park EA, et al. : Anatomic variations of lower extremity venous system in varicose vein patients: demonstration by three-dimensional CT venography. Acta Radiol. 2017; 58 (5): 542–549. PubMed Abstract | Publisher Full Text 16. Ker K, Tansley G, Beecher D, et al. : Comparison of routes for achieving parenteral access with a focus on the management of patients with Ebola virus disease. Cochrane Database Syst. Rev. 2015; 2015 : CD011386. PubMed Abstract | Publisher Full Text | Free Full Text 17. Senevirathne SAMDRU, Nimana HKV, Pirannavan R, et al. : Anatomic description of the distal great saphenous vein to facilitate peripheral venous access during resuscitation: a cadaveric study. Patient Saf. Surg. 2023; 17 (1): 2. PubMed Abstract | Publisher Full Text | Free Full Text 18. Human P, Franz T, Scherman J, et al. : Dimensional analysis of human saphenous vein grafts: implications for external mesh support. J. Thorac. Cardiovasc. Surg. 2009; 137 : 1101–1108. PubMed Abstract | Publisher Full Text 19. Ramasastry SS, Dick GO, Futrell JW: Anatomy of the saphenous nerve: relevance to saphenous vein stripping. Am. Surg. 1987; 53 (5): 274–277. PubMed Abstract 20. Holme 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; 154 (11-12): 631–633. PubMed Abstract 21. Murlimanju BV, Tonse M: Morphometry of saphenofemoral junction. Publisher Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 04 Mar 2026 ADD YOUR COMMENT Comment Author details Author details 1 Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India Latha V Prabhu Roles: Conceptualization, Data Curation, Investigation, Methodology B.V. Murlimanju Roles: Investigation, Validation, Writing – Original Draft Preparation M. Praveen Shenoy Roles: Data Curation, Investigation, Methodology Mangala M Pai Roles: Writing – Review & Editing Mamatha Tonse Roles: Conceptualization, Data Curation, Investigation, Methodology Ashwin R Rai Roles: Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 11 May 2026, 15:349 https://doi.org/10.12688/f1000research.178143.2 version 1 Published: 04 Mar 2026, 15:349 https://doi.org/10.12688/f1000research.178143.1 Copyright © 2026 V Prabhu L et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article V Prabhu L, Murlimanju BV, Shenoy MP et al. Clinically relevant topography of the great saphenous vein and saphenofemoral junction, a study from adult embalmed cadavers [version 1; peer review: 1 approved with reservations, 1 not approved] . F1000Research 2026, 15 :349 ( https://doi.org/10.12688/f1000research.178143.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 04 Mar 2026 Views 0 Cite How to cite this report: Elamin AAE. Reviewer Report For: Clinically relevant topography of the great saphenous vein and saphenofemoral junction, a study from adult embalmed cadavers [version 1; peer review: 1 approved with reservations, 1 not approved] . F1000Research 2026, 15 :349 ( https://doi.org/10.5256/f1000research.196496.r466796 ) The direct URL for this report is: https://f1000research.com/articles/15-349/v1#referee-response-466796 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 01 Apr 2026 Abdalla Ahmed Eldaw Elamin , Ras Al Khaimah Medical and Health Sciences University College of Medical Sciences (Ringgold ID: 286652), Ras Al-Khaimah, United Arab Emirates Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.196496.r466796 This study highlights anatomical variations of the saphenous opening and the relationship of the saphenous nerve to the great saphenous vein. The authors measure the width and length of the saphenous opening, describe its range of shapes, and determine the ... Continue reading READ ALL This study highlights anatomical variations of the saphenous opening and the relationship of the saphenous nerve to the great saphenous vein. The authors measure the width and length of the saphenous opening, describe its range of shapes, and determine the distance of the saphenofemoral junction from the pubic tubercle. They also assess the diameter of the great saphenous vein near the medial malleolus and measure its distance from the medial malleolus. In addition, the study presents a bilateral and gender-based comparison of the saphenous opening. Overall, it provides a useful reference for dissection, imaging, and preoperative planning. The second paragraph of the introduction is not supported by any references, and the overall introduction appears brief. Figure 1 is included in the introduction; however, it would be more appropriate to place it in the Methods section. The quality of Figure 2 is low and should be improved. For better clarity, it is recommended to add clear demarcations between A, B, and C in Figure 3 and to change the arrow color in Figure 4. Additionally, in figure 3, outlining the margin of the saphenous opening with color or dashed lines would improve clarity. The repeated content related to limitations in the discussion section should be removed. Furthermore, the discussion does not address the results of the bilateral and gender comparisons; these findings should be contrasted with previous studies. Kindly provide the complete bibliographic details for the last reference. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Stereology, Anatomy, Electromagnetic field effects on organsims, Peripheral nerve regeneration. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Elamin AAE. Reviewer Report For: Clinically relevant topography of the great saphenous vein and saphenofemoral junction, a study from adult embalmed cadavers [version 1; peer review: 1 approved with reservations, 1 not approved] . F1000Research 2026, 15 :349 ( https://doi.org/10.5256/f1000research.196496.r466796 ) The direct URL for this report is: https://f1000research.com/articles/15-349/v1#referee-response-466796 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 13 May 2026 Mamatha Tonse , Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India 13 May 2026 Author Response Dear Sir, Thank you so much for the peer review of our manuscript and the expert comments. The manuscript has been revised as per your suggestion. In the methodology ... Continue reading Dear Sir, Thank you so much for the peer review of our manuscript and the expert comments. The manuscript has been revised as per your suggestion. In the methodology section, the identification of the great saphenous vein in the saphenous fascia and dissection within the saphenous compartment, between the superficial fascia and the muscular fascia was added as per the reviewer’s opinion. The veins located superficial to the saphenous fascia were not considered as the great saphenous vein. It was also mentioned in the methodology that the present study does not report on the presence of accessory anterior saphenous veins or the Giacomini vein. The study limitation is added in the discussion section regarding the widespread availability of high-resolution ultrasonography and other imaging techniques for the more precise and clinically relevant data in living subjects. Few more recent references were cited for the introduction section. The Figure 2 was rewritten and Figures 3-4 were revised as per the suggestions of the reviewer. The discussion was revised with more description on the side-based and gender-based variations. The limitations were revised. The last reference (of the dataset) was given in full. Dear Sir, Thank you so much for the peer review of our manuscript and the expert comments. The manuscript has been revised as per your suggestion. In the methodology section, the identification of the great saphenous vein in the saphenous fascia and dissection within the saphenous compartment, between the superficial fascia and the muscular fascia was added as per the reviewer’s opinion. The veins located superficial to the saphenous fascia were not considered as the great saphenous vein. It was also mentioned in the methodology that the present study does not report on the presence of accessory anterior saphenous veins or the Giacomini vein. The study limitation is added in the discussion section regarding the widespread availability of high-resolution ultrasonography and other imaging techniques for the more precise and clinically relevant data in living subjects. Few more recent references were cited for the introduction section. The Figure 2 was rewritten and Figures 3-4 were revised as per the suggestions of the reviewer. The discussion was revised with more description on the side-based and gender-based variations. The limitations were revised. The last reference (of the dataset) was given in full. Competing Interests: NIL Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 13 May 2026 Mamatha Tonse , Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India 13 May 2026 Author Response Dear Sir, Thank you so much for the peer review of our manuscript and the expert comments. The manuscript has been revised as per your suggestion. In the methodology ... Continue reading Dear Sir, Thank you so much for the peer review of our manuscript and the expert comments. The manuscript has been revised as per your suggestion. In the methodology section, the identification of the great saphenous vein in the saphenous fascia and dissection within the saphenous compartment, between the superficial fascia and the muscular fascia was added as per the reviewer’s opinion. The veins located superficial to the saphenous fascia were not considered as the great saphenous vein. It was also mentioned in the methodology that the present study does not report on the presence of accessory anterior saphenous veins or the Giacomini vein. The study limitation is added in the discussion section regarding the widespread availability of high-resolution ultrasonography and other imaging techniques for the more precise and clinically relevant data in living subjects. Few more recent references were cited for the introduction section. The Figure 2 was rewritten and Figures 3-4 were revised as per the suggestions of the reviewer. The discussion was revised with more description on the side-based and gender-based variations. The limitations were revised. The last reference (of the dataset) was given in full. Dear Sir, Thank you so much for the peer review of our manuscript and the expert comments. The manuscript has been revised as per your suggestion. In the methodology section, the identification of the great saphenous vein in the saphenous fascia and dissection within the saphenous compartment, between the superficial fascia and the muscular fascia was added as per the reviewer’s opinion. The veins located superficial to the saphenous fascia were not considered as the great saphenous vein. It was also mentioned in the methodology that the present study does not report on the presence of accessory anterior saphenous veins or the Giacomini vein. The study limitation is added in the discussion section regarding the widespread availability of high-resolution ultrasonography and other imaging techniques for the more precise and clinically relevant data in living subjects. Few more recent references were cited for the introduction section. The Figure 2 was rewritten and Figures 3-4 were revised as per the suggestions of the reviewer. The discussion was revised with more description on the side-based and gender-based variations. The limitations were revised. The last reference (of the dataset) was given in full. Competing Interests: NIL Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Simka M. Reviewer Report For: Clinically relevant topography of the great saphenous vein and saphenofemoral junction, a study from adult embalmed cadavers [version 1; peer review: 1 approved with reservations, 1 not approved] . F1000Research 2026, 15 :349 ( https://doi.org/10.5256/f1000research.196496.r464718 ) The direct URL for this report is: https://f1000research.com/articles/15-349/v1#referee-response-464718 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 11 Mar 2026 Marian Simka , University of Opole, Opole, Poland Not Approved VIEWS 0 https://doi.org/10.5256/f1000research.196496.r464718 This manuscript presents a study on the anatomy of the great saphenous vein based on dissections of cadaveric specimens. While such investigations were commonly performed in previous centuries, the relevance of this methodology is questionable in the context of modern ... Continue reading READ ALL This manuscript presents a study on the anatomy of the great saphenous vein based on dissections of cadaveric specimens. While such investigations were commonly performed in previous centuries, the relevance of this methodology is questionable in the context of modern anatomical and clinical research. With the widespread availability of high-resolution ultrasonography and other imaging techniques, it is now possible to obtain more precise and clinically relevant data in living subjects. Consequently, it is unclear whether the present cadaver-based approach can provide novel or meaningful scientific insights. Another major concern relates to the identification of the great saphenous vein. According to the current anatomical definition, the great saphenous vein is located within the saphenous compartment, between the superficial (saphenous) fascia and the muscular fascia. Veins located superficial to the saphenous fascia should not be considered the great saphenous vein. The authors do not specify whether the saphenous fascia was identified during dissection. This structure is extremely difficult to reliably identify in embalmed cadavers, which is one of the reasons why such anatomical studies are rarely performed today, as more accurate investigative methods are available. Without clear confirmation that the saphenous compartment was identified, it remains uncertain whether the examined vessels were indeed the great saphenous vein rather than adjacent superficial veins. Furthermore, the manuscript does not report the presence of accessory anterior saphenous veins or the Giacomini vein. Although these anatomical structures are not present in all individuals, they are relatively common and would be expected to appear in at least some specimens. Their absence from the description raises additional concerns regarding the accuracy and completeness of the dissections. Is the work clearly and accurately presented and does it cite the current literature? No Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Not applicable Are all the source data underlying the results available to ensure full reproducibility? No source data required Are the conclusions drawn adequately supported by the results? No Competing Interests: No competing interests were disclosed. Reviewer Expertise: Dr. Marian Simka, specialist in angiology and general surgery, is the associate professor of the Department of Anatomy at the University of Opole, Poland and the associate professor of the Department of Nursing at the College of Applied Sciences in Ruda Śląska, Poland. He is the author of over 200 publications in the field of anatomy, angiology, phlebology, wound healing, vascular surgery and interventional radiology. His research focuses at the pathophysiology, diagnostics and treatment of venous pathologies. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Simka M. Reviewer Report For: Clinically relevant topography of the great saphenous vein and saphenofemoral junction, a study from adult embalmed cadavers [version 1; peer review: 1 approved with reservations, 1 not approved] . F1000Research 2026, 15 :349 ( https://doi.org/10.5256/f1000research.196496.r464718 ) The direct URL for this report is: https://f1000research.com/articles/15-349/v1#referee-response-464718 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 04 Mar 2026 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 Version 2 (revision) 11 May 26 Version 1 04 Mar 26 read read Marian Simka , University of Opole, Opole, Poland Abdalla Ahmed Eldaw Elamin , Ras Al Khaimah Medical and Health Sciences University College of Medical Sciences (Ringgold ID: 286652), Ras Al-Khaimah, United Arab Emirates Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Elamin A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 01 Apr 2026 | for Version 1 Abdalla Ahmed Eldaw Elamin , Ras Al Khaimah Medical and Health Sciences University College of Medical Sciences (Ringgold ID: 286652), Ras Al-Khaimah, United Arab Emirates 0 Views copyright © 2026 Elamin A. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This study highlights anatomical variations of the saphenous opening and the relationship of the saphenous nerve to the great saphenous vein. The authors measure the width and length of the saphenous opening, describe its range of shapes, and determine the distance of the saphenofemoral junction from the pubic tubercle. They also assess the diameter of the great saphenous vein near the medial malleolus and measure its distance from the medial malleolus. In addition, the study presents a bilateral and gender-based comparison of the saphenous opening. Overall, it provides a useful reference for dissection, imaging, and preoperative planning. The second paragraph of the introduction is not supported by any references, and the overall introduction appears brief. Figure 1 is included in the introduction; however, it would be more appropriate to place it in the Methods section. The quality of Figure 2 is low and should be improved. For better clarity, it is recommended to add clear demarcations between A, B, and C in Figure 3 and to change the arrow color in Figure 4. Additionally, in figure 3, outlining the margin of the saphenous opening with color or dashed lines would improve clarity. The repeated content related to limitations in the discussion section should be removed. Furthermore, the discussion does not address the results of the bilateral and gender comparisons; these findings should be contrasted with previous studies. Kindly provide the complete bibliographic details for the last reference. Is the work clearly and accurately presented and does it cite the current literature? Partly Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Stereology, Anatomy, Electromagnetic field effects on organsims, Peripheral nerve regeneration. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above. reply Respond to this report Responses (1) Author Response 13 May 2026 Mamatha Tonse, Department of Anatomy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India Dear Sir, Thank you so much for the peer review of our manuscript and the expert comments. The manuscript has been revised as per your suggestion. In the methodology section, the identification of the great saphenous vein in the saphenous fascia and dissection within the saphenous compartment, between the superficial fascia and the muscular fascia was added as per the reviewer’s opinion. The veins located superficial to the saphenous fascia were not considered as the great saphenous vein. It was also mentioned in the methodology that the present study does not report on the presence of accessory anterior saphenous veins or the Giacomini vein. The study limitation is added in the discussion section regarding the widespread availability of high-resolution ultrasonography and other imaging techniques for the more precise and clinically relevant data in living subjects. Few more recent references were cited for the introduction section. The Figure 2 was rewritten and Figures 3-4 were revised as per the suggestions of the reviewer. The discussion was revised with more description on the side-based and gender-based variations. The limitations were revised. The last reference (of the dataset) was given in full. View more View less Competing Interests NIL reply Respond Report a concern Elamin AAE. Peer Review Report For: Clinically relevant topography of the great saphenous vein and saphenofemoral junction, a study from adult embalmed cadavers [version 1; peer review: 1 approved with reservations, 1 not approved] . F1000Research 2026, 15 :349 ( https://doi.org/10.5256/f1000research.196496.r466796) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/15-349/v1#referee-response-466796 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2026 Simka M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 11 Mar 2026 | for Version 1 Marian Simka , University of Opole, Opole, Poland 0 Views copyright © 2026 Simka M. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Not Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This manuscript presents a study on the anatomy of the great saphenous vein based on dissections of cadaveric specimens. While such investigations were commonly performed in previous centuries, the relevance of this methodology is questionable in the context of modern anatomical and clinical research. With the widespread availability of high-resolution ultrasonography and other imaging techniques, it is now possible to obtain more precise and clinically relevant data in living subjects. Consequently, it is unclear whether the present cadaver-based approach can provide novel or meaningful scientific insights. Another major concern relates to the identification of the great saphenous vein. According to the current anatomical definition, the great saphenous vein is located within the saphenous compartment, between the superficial (saphenous) fascia and the muscular fascia. Veins located superficial to the saphenous fascia should not be considered the great saphenous vein. The authors do not specify whether the saphenous fascia was identified during dissection. This structure is extremely difficult to reliably identify in embalmed cadavers, which is one of the reasons why such anatomical studies are rarely performed today, as more accurate investigative methods are available. Without clear confirmation that the saphenous compartment was identified, it remains uncertain whether the examined vessels were indeed the great saphenous vein rather than adjacent superficial veins. Furthermore, the manuscript does not report the presence of accessory anterior saphenous veins or the Giacomini vein. Although these anatomical structures are not present in all individuals, they are relatively common and would be expected to appear in at least some specimens. Their absence from the description raises additional concerns regarding the accuracy and completeness of the dissections. Is the work clearly and accurately presented and does it cite the current literature? No Is the study design appropriate and is the work technically sound? No Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Not applicable Are all the source data underlying the results available to ensure full reproducibility? No source data required Are the conclusions drawn adequately supported by the results? No Competing Interests No competing interests were disclosed. Reviewer Expertise Dr. Marian Simka, specialist in angiology and general surgery, is the associate professor of the Department of Anatomy at the University of Opole, Poland and the associate professor of the Department of Nursing at the College of Applied Sciences in Ruda Śląska, Poland. He is the author of over 200 publications in the field of anatomy, angiology, phlebology, wound healing, vascular surgery and interventional radiology. His research focuses at the pathophysiology, diagnostics and treatment of venous pathologies. I confirm that I have read this submission and believe that I have an appropriate level of expertise to state that I do not consider it to be of an acceptable scientific standard, for reasons outlined above. reply Respond to this report Responses (0) Simka M. Peer Review Report For: Clinically relevant topography of the great saphenous vein and saphenofemoral junction, a study from adult embalmed cadavers [version 1; peer review: 1 approved with reservations, 1 not approved] . F1000Research 2026, 15 :349 ( https://doi.org/10.5256/f1000research.196496.r464718) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. 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