Axillary Vessels and Brachial Plexus Traumas in Abidjan: Lesional Aspects and Surgical Difficulties ()
Author(s)
Yoboua Aimé Kirioua-Kamenan1,2*,
Assoumou Lucien Asseke1,
Jean Calaire Degré1,2,
Koutoua Eric Katché1,2,
Ibrahim Junior Yeo3,
Marc Hervé Kassi1,
Zolé Cedrick Doh4,
Kwadjau Anderson Amani1,2,
Kouassi Antonin Souaga1,2,
Kouassi Flavien Kendja1,2
Affiliation(s)
1Cardiovascular Surgery Department, Abidjan Heart Institute, Abidjan, Côte d’Ivoire.
2Department of Surgery and Surgical Specialties, Félix Houphouët-Boigny University, Abidjan, Côte d’Ivoire.
3Thoracic Surgery Department, Abidjan Heart Institute, Abidjan, Côte d’Ivoire.
4Anesthesia and Intensive Care Department, Abidjan Heart Institute, Abidjan, Côte d’Ivoire.
ABSTRACT
Introduction-Objectives: Through the presentation of epidemiological, anatomo-clinical and
surgical aspects, we report our experience in the management of traumatic
axillary lesions. Materials and Methods: A descriptive retrospective study was based on the medical
records of patients who suffered vascular axillary and/or brachial plexus
trauma and who underwent surgical repair at the Abidjan Cardiology Institute
from January 2008 to June 2022. Epidemiological, anatomo-clinical and surgical data
were studied. Results: Thirty-four medical files belonging to 33 men and one woman, aged 32 on
average, were collected. The circumstances of occurrence were dominated by the
stab wound (n = 22). The
combinations of injuries were as follows: associated involvement of the
axillary artery and vein (n = 4); isolated involvement of axillary artery (n = 3); isolated involvement of the axillary vein (n = 2); associated involvement of
the axillary artery and brachial plexus (n = 17); associated involvement of the axillary artery and
vein and brachial plexus (n = 08). Anatomic lesions included acute arterial
lesions (n = 29) and arteriovenous fistula (n = 1) and false aneurysms (n = 4).
All patients were operated on under
general anesthesia; vascular repair included direct suturing (n = 16), arterial
and venous bypass using a long saphenous graft (n = 9), prosthetic arterial
bypass (n = 5) and prosthetic flattening-graft (n = 4). Brachial plexus surgery consisted of an end-to-end
anastomosis of each transected bundle in all cases (n = 25). The medium-term
postoperative course was marked by success without functional sequelae in 88.24%
of cases (n = 30) and by the persistence of distal paralysis of the thoracic limb
after 6 months in 05.88% (n = 2) of all patients, i.e., 8% of patients who presented with brachial plexus injury. Conclusion: The concomitant surgical treatment of these axillary vascular and nerve lesions
has given good results. However, if paralysis of the thoracic limb persists
after 6 to 12 months, the patient should be referred to a specialist in
brachial plexus surgery.
Share and Cite:
Kirioua-Kamenan, Y. , Lucien Asseke, A. , Degré, J. , Katché, K. , Yeo, I. , Kassi, M. , Doh, Z. , Amani, K. , Souaga, K. and Kendja, K. (2023) Axillary Vessels and Brachial Plexus Traumas in Abidjan: Lesional Aspects and Surgical Difficulties.
World Journal of Cardiovascular Surgery,
13, 85-92. doi:
10.4236/wjcs.2023.135008.
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