Systems and methods for deploying a prosthesis in a tissue region in a hollow body organ or blood vessel provide a first prosthesis and a second prosthesis, each having a prosthetic material and a scaffold that supports the prosthetic material. The first prosthesis has a proximal neck region, and the second prosthesis has an end region. The end region is sized and configured to telescopically fit with the proximal neck region to form a composite prosthesis. The systems and methods manipulate a fastener attachment assembly to implant at least one fastener to secure the composite prosthesis in the tissue region.
