* risk of bleeding: * clinical: active bleeding, major surgery in the last 30 days, gastrointestinal bleeding within 30 days; * laboratory: platelet count \<50,000, inr\> 2 or aptt\> 50s; * known or suspected adverse reaction to ufh, including heparin-induced thrombocytopenia (tih); * adverse reaction or allergy to tocilizumab; * use of any of the following treatments: ufh to treat a thrombotic event within 12 hours before inclusion; hpbm in therapeutic dose within 12 hours before inclusion; warfarin (if used 7 days before and if inr greater than 2; thrombolytic therapy within 3 days before; and use of glycoprotein iib / iiia inhibitors within the previous 7 days; * pregnant or lactating; * absolute indication of anticoagulation due to atrial fibrillation or diagnosed thromboembolic event; * refusal by family members and / or patient; * active tuberculosis; * bacterial infection confirmed by culture; * neutropenia (\<1000 neutrophils / mm3); * use of another immunosuppressive therapy that is not a corticosteroid; * septic shock.

* risk of bleeding: * clinical: active bleeding, major surgery in the last 30 days, gastrointestinal bleeding within 30 days; * laboratory: platelet count \<50,000, inr\> 2 or aptt\> 50s; * known or suspected adverse reaction to ufh, including heparin-induced thrombocytopenia (tih); * adverse reaction or allergy to tocilizumab; * use of any of the following treatments: ufh to treat a thrombotic event within 12 hours before inclusion; hpbm in therapeutic dose within 12 hours before inclusion; warfarin (if used 7 days before and if inr greater than 2; thrombolytic therapy within 3 days before; and use of glycoprotein iib / iiia inhibitors within the previous 7 days; * pregnant or lactating; * absolute indication of anticoagulation due to atrial fibrillation or diagnosed thromboembolic event; * refusal by family members and / or patient; * active tuberculosis; * bacterial infection confirmed by culture; * neutropenia (\<1000 neutrophils / mm3); * use of another immunosuppressive therapy that is not a corticosteroid; * septic shock.

- risk of bleeding: - clinical: active bleeding, major surgery in the last 30 days, gastrointestinal bleeding within 30 days; - laboratory: platelet count <50,000, inr> 2 or aptt> 50s; - known or suspected adverse reaction to ufh, including heparin-induced thrombocytopenia (tih); - adverse reaction or allergy to tocilizumab; - use of any of the following treatments: ufh to treat a thrombotic event within 12 hours before inclusion; hpbm in therapeutic dose within 12 hours before inclusion; warfarin (if used 7 days before and if inr greater than 2; thrombolytic therapy within 3 days before; and use of glycoprotein iib / iiia inhibitors within the previous 7 days; - pregnant or lactating; - absolute indication of anticoagulation due to atrial fibrillation or diagnosed thromboembolic event; - refusal by family members and / or patient; - active tuberculosis; - bacterial infection confirmed by culture; - neutropenia (<1000 neutrophils / mm3); - use of another immunosuppressive therapy that is not a corticosteroid; - septic shock.

- risk of bleeding: - clinical: active bleeding, major surgery in the last 30 days, gastrointestinal bleeding within 30 days; - laboratory: platelet count <50,000, inr> 2 or aptt> 50s; - known or suspected adverse reaction to ufh, including heparin-induced thrombocytopenia (tih); - adverse reaction or allergy to tocilizumab; - use of any of the following treatments: ufh to treat a thrombotic event within 12 hours before inclusion; hpbm in therapeutic dose within 12 hours before inclusion; warfarin (if used 7 days before and if inr greater than 2; thrombolytic therapy within 3 days before; and use of glycoprotein iib / iiia inhibitors within the previous 7 days; - pregnant or lactating; - absolute indication of anticoagulation due to atrial fibrillation or diagnosed thromboembolic event; - refusal by family members and / or patient; - active tuberculosis; - bacterial infection confirmed by culture; - neutropenia (<1000 neutrophils / mm3); - use of another immunosuppressive therapy that is not a corticosteroid; - septic shock.