Optical pressure sensor assemblies that can be used with existing catheters and imaging systems. Pressure sensors may be compatible with atherectomy and occlusion-crossing catheters, where intravascular pressure measurements at various vessel locations are needed to determine treatment efficacy. The pressure sensors may employ an optical pressure measurement mechanism using optical interferometry, and may be integrated with existing imaging modalities such as OCT. The pressure sensor assemblies may include a movable membrane that deflects in response to intravascular pressure; an optical fiber that transmits light to the movable membrane and receives light reflected or scattered back from the movable membrane into the fiber; and a processor or controller configured to determine the distance traveled by the light received in the fiber from the movable membrane, where the distance traveled is proportional to the intravascular pressure exerted against the membrane.