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66; 95% confidence interval (CI), 0.47 to 0.93]. The SC approach was also associated with a decreased incidence of catheter malposition, relative to that observed for the IC approach [odds ratio, 0.24; 95% CI, 0.13 to 0.46]. The SC approach did not reduce the time required for cannulation [mean difference, -74.74; 95% CI, -157.80 to 8.33], and there were no differences in the incidence of artery puncture [odds ratio, 0.60; 95% CI, 0.29 to 1.23] or pneumothorax [odds ratio, 0.89; 95% CI, 0.33 to 2.40]. CONCLUSION Our findings suggest tha