Blend tomatoes to a sauce. I use a stick blender to do this. Set aside.
Heat olive oil and butter in large sauce pan. Saute loose sausage until cooked through. Add diced onion for about 3 minutes. Add garlic, and sautè about a minute. Add tomatoes that have been blended to a puree.
Add in fresh herbs such as parsley and basil (remove later)
Cook for twenty minutes.
Add in vodka.
Stir, simmering on low for twenty or more minutes. Taste to make sure alcohol has burned off before adding in cream.
Add in heavy cream. Stir.
Stir in a 1/2 cup freshly grated parmesan or pecorino cheese
Add in crushed red pepper.
Cook pasta according to directions for al dente.
Serve pasta in large bowl, and add just enough of the sauce you need, making sure to scoop up the sausage into the bowl. You may have some sauce left over.
Serve with more parmesan or pecorino cheese.