Place garlic and pine nuts in a food processor. Pulse until finely chopped. Add Parmesan, red pepper, basil leaves, salt and pepper. Pulse until well combined. With the motor running, add olive oil through the feed tube and process until incorporated. Set aside.
Cook pasta according to package directions. Drain and return to the pot. Add the pesto to the pasta and stir to combine. Stir in heavy cream if desired for a creamier sauce. Heat until warmed through. Serve immediately.