I believe there might be a misunderstanding in your question. The term "Rota Ablation" is not a standard medical procedure or a recognized term in the context of angioplasty or coronary interventions. It's possible that you meant "Rotational Atherectomy" instead.Rotational Atherectomy, also known as Rotablation, is a specialized technique used in certain complex cases of coronary artery disease to treat severely calcified lesions that may be resistant to traditional balloon angioplasty and stenting.During rotational atherectomy, a tiny, high-speed rotational burr, known as a "rotablator," is threaded through the artery on a flexible wire. The rotablator has diamond-coated burrs at its tip, which can spin at high speeds (up to 200,000 revolutions per minute). When the rotablator is activated, it grinds away and pulverizes the calcified plaque, creating microscopic particles that are small enough to be cleared by the body's natural processes.

Complex angioplasty for chronic total occlusion (CTO) is a challenging and specialized procedure used to treat complete blockages in coronary arteries that have been present for an extended period, typically for three months or more. CTOs are caused by the buildup of atherosclerotic plaque that completely obstructs the artery, preventing blood flow to the heart muscle.CTO angioplasty involves the use of specialized techniques and equipment to navigate and open the completely occluded artery. The procedure is often performed by highly skilled interventional cardiologists with expertise in treating complex coronary artery disease.The CTO angioplasty procedure typically involves the following steps:Coronary Angiography: Before attempting CTO angioplasty, a coronary angiography is performed to visualize the blocked artery and assess the anatomy of the occlusion. This helps the interventional cardiologist plan the approach and choose the appropriate equipment.Guide Wire Passage: The first step in CTO angioplasty is to navigate a specialized guide wire through the occluded artery. This requires exceptional skill and experience, as the guide wire must traverse the narrow and tortuous channels created by the blockage.Subintimal or Intraluminal Crossing: There are two main techniques for crossing the CTO: subintimal and intraluminal. In the subintimal approach, the guide wire is directed into the vessel wall (subintimal space) around the blockage and then re-enters the true lumen (the normal artery) beyond the occlusion. In the intraluminal approach, the guide wire is advanced through the center of the blockage within the true lumen.

Complex angioplasty for bifurcation PCI (percutaneous coronary intervention) is a specialized and challenging procedure used to treat significant blockages or narrowing occurring at the site of a bifurcation in the coronary arteries. Bifurcation refers to the point where a main coronary artery divides into two branches, creating a Y-shaped configuration. These bifurcation lesions can be more complex to treat compared to non-bifurcation lesions due to their unique anatomical features.During bifurcation PCI, the interventional cardiologist navigates a thin, flexible catheter through the arterial system to reach the location of the bifurcation. The main goal is to open both the main branch and the side branch of the bifurcation to restore adequate blood flow to the heart muscle.