Constant crashing in areas only fixed by clean installs

Hey, I have had an issue trying to play through the acts on a new character. I have the occassional crash or seven through the game normally but sometimes it'll get stuck on an instance and be unable to proceeed crashing immediately. Switching zones or swapping characters then swapping back does not fix it. I have to clean install to progress another 10-15 minutes. Happened at Renly with the reforging spikes in act 1, is currently happening at Halani Gates in act 2.

Fixes attempted:

rebooting
switching character then switching back
bios update
driver update
reverting to windows 10
being on 22h10
switching to vulkan with medium textures,
lowering graphic settings
Going from full screen to windowed mode
preload loader option
switching back to dx11 or dx12
poe uncrasher
BeS app
Deleting shader cache
Limiting shader cache size to 100gb
setting ram usage to 6 gb min to 8 gb max
verified file integrity
set compatibility windows 8

Please advise/help, the game is completely unplayable for me and I have spent in excess of 20 hours trying to troubleshoot fixes to no avail.

System specs:
Windows 10 pro
Version: 10.0.19045 build 19045
B660m Phantom Gaming motherboard
x64 PC based
i5-12700kf 3700mhz processor
32 gb ram
RTX3060 gfx