Carotid ultrasound is a noninvasive imaging test that uses sound waves to visualize the carotid arteries in the neck and measure blood flow. It is commonly used to detect carotid stenosis, plaque characteristics, and flow disturbances that increase stroke risk. The test provides information on the degree of narrowing, plaque composition, and sometimes the presence of ulcerations or thrombus. Because it is safe, relatively inexpensive, and widely available, carotid ultrasound is a standard tool in evaluating patients with TIAs, strokes, or risk factors for cerebrovascular disease. In underwriting, it often appears in APS records for older or high-risk applicants.

Underwriters review carotid ultrasound reports when applicants have documented carotid disease, TIAs, or neurologic symptoms. They look at percentage stenosis in each artery, plaque descriptions, and recommendations for medical or surgical management. Normal or only mildly abnormal findings can support more favorable underwriting outcomes, while severe stenosis or rapidly progressive disease leads to higher ratings. Advisors working with older clients or those with vascular disease should be prepared to obtain and submit carotid ultrasound reports. Understanding carotid ultrasounds helps advisors decode imaging terminology and anticipate its impact on underwriting decisions.