Benefits and risks

Information for the public

When NICE looked at the evidence, it decided that there is not much good evidence to show that optical coherence tomography (OCT) works well. The 14 studies that NICE looked at involved a total of 1692 patients.

Generally, they showed the following:

there were fewer deaths and heart attacks in patients who had procedures assessed by both OCT and coronary angiography imaging than in patients who had coronary angiography alone, but some patients who had both imaging methods needed further procedures
in a study comparing OCT or ultrasound imaging to guide stent placement and expansion, the results were less good when OCT was used
in a study where OCT results suggested that stent treatment of narrowed vessels was not needed, no patients had a heart attack within 5 months.

The studies showed that the risks of OCT during imaging included:

puncturing or tearing of the arteries
problems with the heart rhythm or rate
multiple air bubbles or blood clots blocking the arteries
the catheter breaking or a wire becoming trapped inside a stent
short-lasting chest pain during the procedure.

One person who had a tear in an artery during the procedure died of a heart attack 7 days later, despite further surgery.

NICE was also told that there was a possible risk of emergency treatment being needed because of some of the problems described above.

If you want to know more about the studies see the guidance. Ask your health professional to explain anything you don't understand.