STL is a 3D format — do you want it to be a 3D model?
It should work to just trace the file as it is and cut that — it would of course be ideal to get a better quality original image, ideally one which is b/w, not greyscale.
The thing is, you don’t want pixels, unless you are going to use a tool such as:
Consider, the original was actually linework — it was actually an engraving, done by applying a tool to a material and cutting away at it in lines (or if a copperplate, by using burin to make depressions in a plate) — if we could re-create the motion of the original artist, as to some degree we do with a player piano, we could get a better result, which more closely approximated the original.
Ah so I want to use illustrator to make a vector for 2D or for 3D I’d have to make it in Blender or SolidWorkd right?
I did a couple hours research and it seems people are using: carveco, vetric aspire or fusion 360 to do 3D carvings. They either try to semi-auto extrude the high points using software, or they manually build the image in zbrush, or other 3d software then import to fusion.
Seems the zbrush part is tedious but could be outsourced for $100 on fiverr.
I might have to just stick with 2D for the time being. Will need to research this more in the future.