Raising orgasm to an extreme level of anilihating pleasure! The level being that high, as to where oxygen is immensely decreased. Many people make their own "Garrot", which is similar to a noose, so they can perform the one man/woman band!
A pleasure that can ultimately become a sport of the "Russian Roulette" type.
John Benet Ramsey's alleged perpetrator may have used a Garrot when sexually molesting her.