The Great Saphenous Vein (GSV) is the longest superficial vein, tracing a path from the foot, up the inner leg, and connecting to the deep venous system in the groin. While its function is to return deoxygenated blood from the superficial tissues toward the heart, it is not an irreplaceable vessel. The removal of the GSV is a common medical procedure, often achieved through traditional surgical stripping or newer, minimally invasive techniques like endovenous ablation. This treatment addresses specific health issues where the vein has become dysfunctional and hinders proper circulation.
The Underlying Condition Requiring Removal
The primary reason for treating or removing the GSV is Chronic Venous Insufficiency (CVI). This progressive condition develops when the one-way valves inside the vein become weakened or damaged, preventing them from closing completely. This valve failure causes venous reflux, where blood flows downward with gravity instead of upward toward the heart.
The resulting pooling of blood creates high pressure within the vein, leading to its distension and the formation of varicose veins that are visible, twisted, and enlarged. The dysfunctional GSV causes venous hypertension in the lower leg, which can result in symptoms like pain, swelling, and skin changes. Removal of the diseased vein eliminates this source of backward blood flow and the associated high pressure, thereby improving overall venous circulation.
Immediate Post-Procedure Recovery and Care
Following the procedure, patients are typically advised to begin walking immediately. This mobility activates the calf muscle pump, which helps push blood through the remaining healthy veins and minimizes the risk of blood clots. Patients should avoid strenuous activity, heavy lifting, and intense workouts for one to two weeks.
Expected side effects include bruising (ecchymosis) and soreness at the treatment site, usually resolving within a few days to two weeks. Pain management often involves over-the-counter medications like ibuprofen, which also helps reduce inflammation. Consistent use of prescription-strength compression stockings is required post-procedure. These garments support the leg tissues, reduce swelling and bruising, and assist the body in rerouting blood flow through the remaining deep veins.
Physiological Adaptation of Blood Flow
The body’s circulatory system compensates effectively for the absence of the GSV due to its inherent redundancy. The venous system of the legs is divided into superficial veins (like the GSV) and deep veins (such as the femoral vein). The deep venous system handles the vast majority of the leg’s blood return, accounting for approximately 90% of venous blood flow.
When the diseased GSV is removed or sealed shut, the blood flow that previously coursed through it is immediately redirected. This rerouting occurs through the remaining healthy superficial veins and, most significantly, through the perforating veins. Perforating veins connect the superficial and deep systems. Eliminating the source of reflux improves overall circulation, as the deep system is no longer subject to the high pressure caused by the backward-flowing blood. The deep veins manage the slightly increased volume, and the overall efficiency of the leg’s blood return to the heart is restored or improved.
Long-Term Function and Follow-Up Care
The long-term outlook after the removal of a diseased GSV is generally positive, with a significant reduction in symptoms like pain and swelling. Once the source of venous hypertension is removed, the remaining healthy veins function more effectively, leading to improved quality of life. The body maintains healthy circulation without the GSV, as the deep system and collateral veins permanently take over the function.
However, Chronic Venous Insufficiency is a progressive condition, and new issues can arise in other veins over time. Recurrence of varicose veins can occur, sometimes due to neovascularization (new connecting blood vessels at the removal site), or progression of disease in other veins. For this reason, long-term follow-up care is necessary, typically including annual or biennial Duplex ultrasound examinations. These non-invasive scans monitor the health of the deep venous system and check for any signs of new refluxing veins, allowing for early intervention and maintenance of healthy circulation.