you could try getting rid of the scope mipmap fix as i'm unfamiliar with that, but your mods and settings etc seem fine
i'd double-check that there are as few background applications open as possible, even stuff like software for your peripherals i'd close (unless your peripherals require it to function)
it would be a good idea to go through a cleanup of tf2 first if there are as many background applications closed as possible: https://docs.mastercomfig.com/latest/setup/clean_up/
#Constant stutters on DX8
oak plover
if that doesn't help then you can try running through this list of optimizations here: https://docs.mastercomfig.com/latest/os/windows/
(not everything will be applicable to you)
notably disabling overlays and fullscreen optimizations might help in your case but running through as much as possible in that list is a good thing to do
the W10Privacy tool mentioned in that linked page is powerful for minimizing your background load as much as possible although it requires a decent bit of configuration
oak plover
could you record these microstutters with net_graph 4 enabled?
preferably 60fps video (or higher if you're willing/the site you upload it to supports it)
could also have a frametime graph open from something like RTSS if you want
oak plover
i'm seeing a pattern of the microstutters occurring whenever something happens (arrow hits you, etc), and i'm wondering if your RAM has anything to do with it
normally that's a pattern that aligns with storage drive issues but you mentioned that you've already swapped to different drives so it might be something iffy with your RAM timings or something similar; you also mentioned that you're using 24gb of ram which is nonstandard--are you using 3 sticks of ram? is any of your ram a different type of RAM (different brands/manufacturers, gb size, etc)?