Place the clams in a bowl and cover them with cold water. Add a tablespoon of salt and give them a quick swish. Set them aside to soak for 1 hour.
Heat the olive oil in a large deep skillet until shimmering. Add the shallots and saute until translucent. Stir in the garlic and saute until fragrant
Stir the crushed red pepper flakes and tomato paste into the shallots. Add the cherry tomatoes and cook until the tomatoes start to fall apart and become jammy.
Stir the horseradish and Worcestershire sauce into the tomatoes and lay the clams on top. Pour in the vodka and immediately cover the pan. Let the clams steam for 5-7 minutes
Turn the heat down to low and place the bucatini in the skillet. Add the butter and toss to coat.Turn off the heat and add the lemon juice.