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Garrotes are designed to be a quiet and easy method to kill on the RP side. Yet mechanically it has not been easy or quiet.

I would like to see all classes get a bonus to attacks from stealth, particularly while using a Garrote. 

It is worth considering what is going on here. Basically the idea is an attacker gets to essentially kill a target with a single attack. Now, assuming you're a decently competent combatant ANY attack you make in combat is potentially lethal. Why don't most attacks kill? Clearly because the enemy is also skilled/lucky/tough/magical/etc to avoid the damage, survive it, etc. Is there a reason this needs to be different just because the weapon is a garrote? Realistically if you get that wire around the victim's throat they're dead. Unconsciousness will occur in from 7 to 20 seconds. This isn't much different than the almost instant death that would result from being bashed in the head with an axe or run through with a sword.

So, logically we have to invoke the same level of abstraction as with other types of attacks. If the victim isn't killed then they clearly weren't garrotted. The target got a hand on the loop, turned around, broke the attacker's grip on the garrote, or just plain avoided it. Clearly, since they were hit, they expended some 'plot armor' (hit points) in doing so, but again no more or less than with any other weapon attack. There's no reason to assume the target is being held by the ligature, and in fact if they were they'd be dead already by the end of one round (at least unconscious).

Thus I would argue that the garrote doesn't need any special rules at all. It works like any other weapon. If you gank a minion with it, they're just dead. A skilled rogue attacking with surprise may be able to kill off standard monsters too. Any monster beyond that clearly isn't enough of a mook to be dispatched this way, or else will only succumb after a long struggle (IE multiple attacks until you finally get the ligature in place).

I agree on the SC for assassination type operations. It works fine as these aren't really combat situations. In that case the garrote's weapon mechanics are irrelevant, though its form and such may well be relevant from an RP perspective (IE you can keep the thing in your pocket and it is going to be hard for someone to find on you, and silent).

I'm not crazy about skill checks to replace combat.  It means combat has two different subsytems for resolution and that seems a bit overcomplicated.  Also, how do I have a NPC attack PCs with a garrotte? 

If we're going to hyperrealism, then a garrotte is a two-handed weapon that inflicts slashing damage, that can only be used in the surprise round, and only against medium or smaller enemies wearing armor/clothing that exposes their necks.  It allows you to enter a gapple/grab and do choking damage.  While choking, the victim can struggle, but not speak.  If the victim is reduced to 0 before breaking the grab/grapple, then the victim is choked out.  If the victim escapes the grab/grapple, then combat resumes and the person can speak.  The victim may also try something like making noise with his hands and feet, if there's someone else close by.  I'd also allow a thief/rogue to use his sneak attack/backstab on the victim.

Under these rules, a garrotte is a good weapon in the hands of a sneak, particularly one optimized for grabbing/grappling, and can kill low-level creatures pretty quickly, but is unlikely to work on higher level folks.  It doesn't sound too unbalanced.  It's only nominally better than a dagger in the back.