See if your vram memory usage goes up to the limit as the game moves on. In that case you are probably suffering the same vram leak many others reported . Changing textures to low or mid makes you reach max vram usage much slower being able to play a whole game without stutter. This only works before the leakage happend since that memory is already lost and changing that config wont do anything.
In my case i tested and with high textures i can only play around 20 minutes or less without stutter but with low textures it took around 70 minutes to fill my whole memory. I have a RTX 3060ti 8GB and my normal use of vram without leakage is around 6GB (Desktop environment included) maybe your normal vram usage is higher than mine at the moment of starting playing, keep this in mind as you could have less time until reaching max vram usage.
I suspect this could be related to the breaking and generation of breakable object around the map as they are the most common texture related asset being loaded during the game, but i have no real evidence.