Heat a large, deep skillet over medium heat. Remove the Italian sausage from the casing, if necessary, and add it to the pan. Cook until browned and cooked through, breaking the sausage into bite-sized crumbles as it cooks. Remove the sausage from the pan and set aside.
In the same pan, add the onion and sliced mini bell peppers. If the pan seems dry, add a small drizzle of olive oil. Cook over medium heat for about 4–5 minutes, until the vegetables begin to soften.
Add the grated garlic and cook for another 30–60 seconds, just until fragrant.
Keep the vegetables in the pan and add the whole tomatoes. Drizzle the tops of the tomatoes lightly with olive oil and season with salt and black pepper.
Reduce the heat and allow the tomatoes to simmer for approximately 20 minutes, stirring occasionally. As the tomatoes soften and cook through, gently mash them into the onion and pepper mixture to create a rustic tomato sauce.
Meanwhile, bring a large pot of salted water to a boil. Add the cavatappi and cook according to the package directions until just shy of al dente. Before draining, reserve at least 1/2 cup of the pasta water.
Once the tomatoes have cooked down, stir the Spicy Vodka Sauce and heavy cream into the pan. Add the cooked Italian sausage back to the sauce and stir until everything is well combined. Keep over low heat while the pasta finishes cooking.
Add the drained Cavatappi directly to the sauce and toss until well coated.
Sprinkle 1 cup of freshly grated Parmesan over the pasta. Pour 1/4 cup of the reserved hot pasta water over the Parmesan and toss everything together until the cheese melts and the sauce becomes creamy and coats the pasta. Add another splash of pasta water if needed to reach your preferred consistency.
Serve warm with small dollops of ricotta and basil pesto on top. Finish with additional freshly grated Parmesan, if desired.