A system for performing a minimally invasive procedure comprises a flexible catheter with a lumen extending therethrough. The system also comprises an elongate instrument sized for passage through the lumen and an optical coherence tomographic sensor coupled to the elongate instrument. The system also comprises a control system that includes one or more processors. The control system is configured to receive sensor data from the optical coherence tomographic sensor, profile a tissue based on the received sensor data, generate an output signal based on the profiled tissue, and based on receipt of the output signal, generate a command to indicate or affect movement of the elongate instrument.