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Updated: Jun 23, 2026

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

HEMS vs. EMS transfer for acute aortic dissection type A.

Karsten Knobloch¹, Imke Dehn, Nawid Khaladj

¹Plastic, hand and reconstructive surgery, Hannover Medical School, Germany. kknobi@yahoo.com

Air Medical Journal

|May 6, 2009

Summary

Helicopter emergency medical services (HEMS) and ground-based emergency medical services (EMS) show no survival benefit for acute aortic dissection type A (AADA) patients. HEMS transport is significantly more expensive than EMS, offering no survival advantage.

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Novel and Innovative Hybrid Technique for Type A Aortic Dissection

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Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock

Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock

Published on: May 19, 2022

Area of Science:

Cardiovascular Surgery
Emergency Medicine
Medical Transportation

Background:

Acute aortic dissection type A (AADA) is a life-threatening condition requiring rapid medical intervention.
The mode of emergency medical transport, specifically helicopter emergency medical service (HEMS) versus ground-based emergency medical service (EMS), may influence patient outcomes.

Purpose of the Study:

To evaluate the impact of physician-based transportation (HEMS vs. EMS) on short- and long-term survival in patients with AADA.
To compare the cost-effectiveness of HEMS versus EMS for AADA patient transport.

Main Methods:

A cohort of 177 AADA patients admitted to a cardiothoracic surgery department was analyzed.
Cox proportional hazard models, log-rank tests, and Kaplan-Meier survival curves were used to assess survival.
Follow-up data was collected for 93% of patients over an average of 5.75 years.

Main Results:

No significant difference in mortality was observed between HEMS and EMS for primary or interhospital transport (P = .5).
HEMS interhospital transfer was eightfold more expensive than EMS (HEMS: $3,871; EMS: $497; P = .01).
Overall survival at follow-up was 56%, with mortality rates increasing progressively within 30 days post-surgery.

Conclusions:

Neither HEMS nor EMS transport offers a survival advantage for AADA patients.
HEMS transport is substantially more expensive than EMS without providing a demonstrable benefit in survival rates for AADA.
The findings suggest that EMS may be a more cost-effective transport option for AADA patients.