There are many patients in the clinic who need to undergo coronary artery bypass surgery who have either had their saphenous vein stripped or are severely varicose and unusable, making it very difficult to obtain bridge vessel material. With the increasing number of such patients, I feel the need to write an article to give a reminder to those who are not yet aware of the importance of the saphenous vein: protect your saphenous vein and maybe live a better life in the future. 1.What is the saphenous vein? The saphenous vein is an important superficial vein in the lower extremity, starting from the medial end of the dorsal arch of the foot, passing in front of the inner ankle, going up along the medial edge of the lower leg, passing about 50px behind the medial femoral condyle, entering the medial part of the thigh, gradually going forward and penetrating the saphenous vein fissure below the pubic symphysis, and converging into the femoral vein. 2.What is saphenous varicose vein? Because the saphenous vein is a very superficial vein, the blood flows back against the direction of gravity and has a long stroke, so it is prone to varicose veins. It is characterized by thickening of the diameter and thinning of the wall, and the original straight-running veins become curly venous masses, with local blood flow stagnation and slow flow, sometimes causing pain due to thrombosis, and further development will affect the blood supply and nutrition of the local skin, and the skin will gradually become pigmented and broken, which will seriously affect the quality of life. It should be noted that some thin people, the subcutaneous tissue is sparse, the veins are clearly visible on the surface of the body, sometimes the lumen is thicker, the pressure is elastic, but the blood vessel form and travel is normal, such performance is not varicose veins. 3.Who is prone to saphenous varicose vein? It is believed that most patients with saphenous varicose veins have venous valve insufficiency, which reduces the unidirectional flow of blood, so all factors that may increase the difficulty of blood return to the veins of the lower extremities may lead to varicose veins in the lower extremities, including prolonged standing, weight gain, deep vein thrombosis and so on. For example, professions such as teachers, surgeons, nurses, hairdressers, chefs, restaurant waiters, shopping mall shoppers, etc., which require long hours of standing work are at high risk for varicose veins. In addition, pregnant women or patients with huge occupational lesions in the abdominal cavity are also at high risk of varicose veins because of the increased pressure of venous reflux and stagnant blood flow in the lower limbs due to the squeezing of the inferior vena cava by the fetus or other occupational lesions in the abdominal cavity, and these people are also at high risk of deep vein thrombosis in the lower limbs. 4, patients with coronary heart disease need to pay more attention to the protection of the saphenous vein. In recent years, the trend of coronary heart disease patients in China is younger, for this part of patients, especially need to protect your saphenous vein. As we all know, there are three main types of treatment for coronary artery disease (other than heart transplantation): medication, interventional treatment and coronary artery bypass grafting, each for patients with different degrees of disease. Once you have been diagnosed with coronary artery disease, the first priority is secondary prevention (early diagnosis and treatment to improve symptoms, prevent progression and recurrence, and improve prognosis) or tertiary prevention (to prevent complications and reduce mortality) of coronary artery disease. Even so, there are still some patients who are unable to fully control the progression of their disease and eventually need to go to the point of coronary artery bypass grafting. The most important arterial material is the left internal mammary artery, which will be used for the anastomosis of the anterior descending branch, and the most important venous material is the saphenous vein, which will be used for the anastomosis of the other coronary arteries. Although the saphenous vein does not have the same long-term patency as the left internal mammary artery and the radial artery, it has inherent advantages: appropriate lumen thickness, flexible length control, easy access, and few collateral branches (especially in the lower leg), so it will remain the most important bridge material for a long time to come. Imagine how sad it would be when you need to undergo coronary artery bypass grafting, but you have bilateral lower extremity varicose veins and there is not enough bridge material available! At this point, a saphenous vein of adequate length and in good condition would give the surgeon a great deal of ease of choice. It is conceivable that a saphenous vein with proper lumen, few side branches, moderate wall thickness and full elasticity will have a much higher long-term patency rate than a saphenous vein with dilated lumen, many side branches, thick or thin wall and poor elasticity. So, start protecting your saphenous vein now, our goal is not only to keep the saphenous vein from varicose, but to keep it “forever young”. 5.How to protect the saphenous vein? If you are a person who has to stand for a long time, it is recommended to wear elastic stockings at work, starting from a young age, not after 40 years old. The type of elastic stocking is related to the height and circumference of the calf, so when you buy it, have it measured by a professional in order to get the most suitable size, avoiding too tight to affect the comfort of wearing it, and not too loose to lose the protection. Since it is used prophylactically, it is enough to protect up to the knee joint, or slightly above the knee joint, without having to reach the root of the thigh. If you are seriously overweight, it is recommended that you lose weight to control your weight. If you sit for a long time at work, you should always do exercises to elevate your lower limbs, and when conditions allow, get up and move around every hour, not for too long, just walk around the office environment for a minute. If you have diabetes, you should do all the above precautions, and also clean your feet and lower limbs daily to detect skin damage early and treat it in time. If your parents have varicose veins in the lower limbs, you should pay enough attention to prevent them as early as possible to avoid them.