Author(s)

Yoboua Aimé Kirioua-Kamenan^1,2*, Assoumou Lucien Asseke¹, Jean Calaire Degré^1,2, Koutoua Eric Katché^1,2, Ibrahim Junior Yeo³, Marc Hervé Kassi¹, Zolé Cedrick Doh⁴, Kwadjau Anderson Amani^1,2, Kouassi Antonin Souaga^1,2, Kouassi Flavien Kendja^1,2

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.

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.

Brachial Plexus Surgery, Distal Paralysis of the Thoracic Limb, False Aneurysms, Flattening-Prosthetic Graft, Traumatic Axillary Lesions

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.