This was designed to work with Handy Picture Hanger by Geotek, but should pretty much work with any toothed picture hanger. The design includes an elongated "nail" to add as much strength and stability as possible, but I would not suggest hanging super heavy stuff with it. I have tried this with a light canvas that I wanted to hang up, and so far it still hanging.

This was designed to be used with a large command strip refills (the same ones that come with the metal hanging nails or the velcro picture hangers).