Cryonics patients can suffer varying degrees of ischemic damage, including both warm and cold ischemia. Although efforts to minimize warm ischemic damage for cryonics patients are often successful, most cryonics patients suffer lengthy cold ischemia during shipment in water ice to a cryonics facility for cryoprotectant perfusion. Vascular damage due to ischemia impedes perfusion with cryoprotectant solutions intended to eliminate ice formation. Neuronal damage due to cold ischemia is probably not so great as to prevent reconstruction in many cases, but freezing damage can be great when perfusion is poor. Forms of ischemic vascular damage will be reviewed, along with means of mitigating that damage. Finally, the probable impact on neuronal damage will be discussed.