How do I stop annoying stutter in win10 with PCI passthrough

How are the drives attached to the VM? I experienced the same issues when passsing through physical storage devices with virtio, same goes for QCOW and raw disk images as there is a clear bottleneck in the way the emulation of storage devices are handled. If this is the case you may also want to give this a look as it suggests some optimisations you can do to improve disk performance in QEMU/Libvirt that may also help with this issue.

Another option which is what solved it for me was installing Windows onto physical disks and passing through a seperate SATA controller to the virtual machine. If your motherboard has more than one SATA controller to spare you can pass it through to the VM or use a PCIe SATA card and attach to the disks to that.