The impenetrable and ambiguous nature of the proximal cap poses a challenge in antegrade wiring during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). This becomes even more complicated with the presence of a side branch at the proximal cap. However, this complexity can be turned into an advantage with the utilization of the side branch. Balloon inflation within the side branch can modify the proximal cap, thus facilitating the entry of a guidewire - a technique commonly referred to as the “Open Sesame” approach [ ]. Additionally, variations of this technique, such as employing scoring or shockwave lithotripsy balloons, have been described in the literature [ ]. We present a novel technique utilizing rotational atherectomy (RA) applied at the proximal cap and side branch to facilitate wiring into the CTO lesion—a method we term “Rota-Sesame.”