The evidence on the safety of optical coherence tomography (OCT) to guide percutaneous coronary intervention (PCI) shows no major concerns. The evidence on efficacy is limited in quantity and quality. Therefore, this procedure should only be used with special arrangements for clinical governance, consent and audit or research.
Clinicians wishing to undertake OCT to guide PCI should take the following actions.
Inform the clinical governance leads in their NHS trusts.
Ensure that patients understand the uncertainty about the procedure's efficacy and provide them with clear written information. In addition, the use of NICE's information for the public is recommended.
The National Institute for Cardiovascular Outcomes Research runs the UK Central Cardiac Audit Database (UKCCAD) and clinicians should enter details about all patients undergoing OCT to guide PCI onto this database and review local clinical outcomes.
NICE encourages further research into OCT to guide PCI compared against PCI with no intravascular imaging or PCI with intravascular ultrasound. Research outcomes should include data on medium- and long-term clinical outcomes, including the need for revascularisation.