Hypothenar hammer syndrome: Long-term follow-up of selective thrombolysis by 3.0-T MR angiography.
OBJECTIVE
To assess the long-term outcome of selective thrombolysis in patients with hypothenar hammer syndrome by 3.0-T magnetic resonance (MR) angiography.


METHODS
Seven patients (6 men, 1 woman; mean age, 58.6 +/- 14.4 years) were investigated. Long-term follow-up examinations (9-11 years post-interventional) were based on 3.0-T MR angiography. Pre- versus post-thrombolysis images and post-thrombolysis versus long-term follow-up images were compared with respect to arterial diameter. Additionally, changes in patients' symptoms were assessed.


RESULTS
The long-term follow-up examination showed worse contrast filling of the ulnar digits compared to the immediately post-interventional angiographic images only in one patient (14.3%), whereas worse contrast filling of the deep palmar arch or the ulnar artery was registered in three patients (42.9%). Three of seven patients (42.9%) reported worse symptoms, two patients (28.6%) stable symptoms at the long-term follow-up MR angiography. In two patients (28.6%) the change of symptoms could not be observed due to missing post-interventional clinical data.


CONCLUSIONS
At the long-term follow-up, clinically, mild progression was found rather often, whereas with respect to imaging findings progression at the ulnar digits was rare. We assume that collateral vessels might play a major role in the post-interventional follow-up. In many instances the patients' symptoms are not in line with the angiographic findings.
Friedrich
Klaus M
KM
Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. klaus.friedrich@meduniwien.ac.at
Frühwald-Pallamar
Julia
J
Stadlbauer
Andreas
A
Salem
Georg
G
Salomonowitz
Erich
E
D015901:Angiography, Digital Subtraction; D012090:Cumulative Trauma Disorders / Q000150:complications*; D005260:Female; D005385:Fingers / Q000098:blood supply; D005500:Follow-Up Studies; D006225:Hand / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000209:etiology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000175:diagnosis / Q000188:drug therapy*; D017535:Ulnar Artery / Q000293:injuries*