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In this case report an 89-year-old man is described with relapsing gross hematuria under new antithrombotic triple therapy for ACS, PCI and A-fib in the presence of a double-J-stent and bladder catheter, a complex therapeutic challenge. Hospital admissions of these patients already rise over 120.000 a year in the U.S. Adv Case Stud Copyright © Michael AB Naafs 2/2 How to cite this article: Michael AB N. Relapsing Urinary Catheter Bleeding with Triple Antithrombotic Therapy in an Elderly Patient with ACS, PCI and A-fib: A Case Report. Adv Case Stud. 1(4). AICS.000517.2018. DOI: 10.31031/AICS.2018.01.000517 Volume 1 Issue 4 Bleeding under Eliquis can be reversed by a 2-hour infusion of Andexxa, a recombinant human FXa, when bleeding is life-threatening or doesn’t react on stopping apixaban [2]. Although triple therapy with acetylsalicylic acid, clopidogrel and apixaban is tricky with an accumulated risk of bleeding of 15% this treatment can be indicated and necessary in patients with an ACS and PCIs [3]. Following percutaneous coronary interventions (PCIs) antiplatelet agents are required to prevent-in-stent-thrombosis which has a mortality rate of 50% to 70%. Additional atrial fibrillation may also require therapy with a NOAC as apixaban [4-6].