Add the garotte to the blade, and/or replace the blade with the bullet(s) to the lower belly while also adding the garotte, and it's a wrap, Blue. That type of 'stalking and killing an Innocent' is not my favorite, but I'm trying to answer within that 'type' of final 'mood' you seem to be after.
The 'type' of scene can indeed call for the 'large knife, lots of blood' effect; personally, I'd probably still opt for a slightly more 'gentle' overall scene, but that's just me. Oh, violent to be sure because that's the 'point', but maybe not as visually messy as a lot of 'cuts' might engender.
But adding a second 'Death Machine' object means she is being taken 'twice', or 'twice as hard', or something, symbolically. And this is a violent, TOTAL control and LOVE for the VIOLENCE scene from the eyes of the Killer. So I like both methods at once to be bringing her to even more frantic writhings and moanings.....and even more crashing final emotive emissions, more intense!
I don't have it 'in' me, so to speak, to write the paragraph....lol. Love the 'ooomph' and bending forward, that makes for a super screen shot of the IMPACT moment, facially and in terms of the midsection jerking to a penetration......then cut in there for your garotte-edit at that point.....if she's bending or bent over something, table or whatever, that's a perfect place to add the asphyx.
And IF your first penetration is good enough, Blue...or deep enough.....or, if one wishes, 'big' enough, then I'm sure you can get her to emote a reaction that indicates TOTALLY being 'taken' by just that first thrust, not a ton of resistance and 'fight', though of course there will be fierce body struggles. But I want to KNOW she is impacted DEEPLY with that first thrust, Blue.
If you need 'pointers' on 'impact of first thrust', I can help you to get a handle on that.
Or she bends forward into you....and further into the penetrator, of course, maybe leaning entire body weight against you, maybe becoming turned a bit as you work her around so you can garotte her from behind (you are permitted at this point any gratuitous contact between your pants and her ass, kept subtle of course

but you are permitted to THINK such thoughts) with one hand as you continue to hold the penetrator inside her with your other hand.
I know that it 'takes two hands to handle a Whopper', but you'll have to do with one hand for each task here. She can even be holding that penetrator inside herself, all for you, Blue, as you slip the garotte around her neck from behind; she just holds it there and works it during her throes, until you also have the garotte in place and then can use one of your hands for each task....OR, of course, you can pull her INTO you further as you strangle her while she faces you....and naturally rides the blade up and down with each body struggle for breath and each frantic gurgle and each thrashing of what hopefully are beautiful legs.
It works well when those legs go up and down into the air, Blue. Almost can be considered like 'sex', for some. I think Ash can see that image just a wee bit.....since she uses it in every personal death scene she writes.....LOL!!!! Leg movements and 'reactions' tell mostly everything about a woman during sex, they can be wrapped around TIGHTLY and PULLING that Man into her (or other penetrator) or they can represent how absolutely and wantonly pleasurably out of control she is as they simply shiver and quiver and shake and bounce up and down and move every which way.
Such movements are probably good for this clip, Blue.
So while I'm not suggesting a porn-type level, I think you can add more imagination to your original paragraph by including the garotte. You CAN do two things at once, can't you, Blue? I mean, one thing with one hand for your Woman while you're doing another thing with the other hand for your Woman?
The key phrase, Blue, is 'for your Woman'.
And Women expect both of your hands to be 'all in'......all the time.
And tables are hard and good for some scenes, but I think you can use more imagination than that......a fancy marble kitchen counter-top with a huge double sink full of water, with water still running, a huge indoor flower bed.....LOL.....I don't know....a waterbed (not normally found in kitchens, but keep your eyes open, it may be a new trend!)
Or maybe she slips away from you, while still holding the blade her belly, or just her belly if it was a bullet...and staggers into another room,where she falls to her knees in weakness and you apply the garotte since she cannot resist....all while that blade remains inside.....and she moves constantly against it...in....and out....in...and out.....vewy subtle, Blue......I just never loved the 'slab' or 'table' image, but I have no clue if that is a better 'sell' for such a scene than some other 'object' to drape over. But all of this can take place in the kitchen, too, it's easier for your rookie Producers.....
Has to be something other than just YOU to drape over, Blue, of course.

We can't have too many 'sticking points' in the same scene, you know.
Or maybe you don't know.
There is something very erotic (cannot understand why, of course...lol) about the female body draped over a lap or something while being garotted from behind, so her body moves up and down and up and down right INTO the camera; many interesting angles to film various aspects of her body and face in such a scene. A blade she is holding, and/or you are helping her to hold, within her as you pull tighter and tighter on her neck, this would also not be a bad thing. Again, I'm not saying to go 'too explicitly' far with the movements sexually, but I think you, as the Actress will, get the point.
How's that for not answering your question? Actually, it's not bad for a reply that does not answer what you asked!
I remain successful!
Sometimes, all I can do is to prick the imagination of my Man and let him floe from there. Other times I can lead the effort, but this time I'm just getting you into my floes......er, NO, I mean YOU into your creative flow, Blue.
And, as I have done in the past, Blue, I waive all normal Consultant fees for this project, it's all gratis.....or 'on me', so to speak.
'in' me, 'on' me, the only difference is the 'I' so I figure it's the same thing. One letter never matters much, right? I admit I once had an ego, I wore that scarlet "A" they gave me for years with pride, once I knew it stood for "Astute". Some said that in my case it meant 'Aphrodite' because of my astonishing beauty, but I'm much too humble to ever accept such platitudes.
But I loved that scarlet letter, never got so many looks in my Life as when I wore it, so I wore it every day!
And they say Blondes are bimbos....HA!
Sandi