Question

The Great saphenous vein graft was used for a patient in CABG. Post surgery the patient is having a neuralgia on the medial aspect of leg and foot. Which nerve has been injured?

• A. Saphenous Nerve
• B. Femoral vein
• C. Profunda femoris vein
• D. Popliteal vein

Answer 1

The Correct Option is A

In CABG surgery, the Great Saphenous Vein (GSV) is harvested from the medial aspect of the leg. The nerve injured in this procedure causing medial leg and foot neuralgia is the $\text{Saphenous Nerve}$.

Anatomy of the Saphenous Nerve:
- Largest cutaneous branch of the femoral nerve
- Accompanies the great saphenous vein throughout its course along the medial leg
- Provides sensory supply to the medial aspect of the leg, ankle, and foot

Clinical correlation:
Saphenous neuralgia after GSV harvest for CABG is a well-known complication. Symptoms include:
- Anaesthesia (numbness) in the medial leg/foot territory
- Hyperaesthesia and pain (neuralgia) in early post-operative period
- Pain typically disappears within 5 days to 8 weeks
- Anaesthesia may persist up to 2 months post-operatively

Why not the other options?
Options B (Femoral vein), C (Profunda femoris vein), and D (Popliteal vein) are all veins -- injury to veins does not produce neuralgia (nerve pain). The question specifically asks about a nerve injury causing neuralgia.

\[\boxed{\text{Saphenous Nerve}}\]