A system for selective activation of a nerve trunk using a transvascular reshaping lead is provided. One aspect of this disclosure relates to a system for spreading nerve bundles in a nerve trunk. The system includes a lead adapted to be chronically implanted in a blood vessel proximate a nerve trunk, and having an expandable portion adapted to be expanded to reshape the blood vessel to an elongated shape and to reshape the nerve trunk into an elongated shape to spread nerve bundles of the nerve trunk. The system also includes a plurality of electrodes and an implantable device coupled to the lead, where an electrical signal is delivered from the implanted medical device to one of the plurality of electrodes to transvascularly deliver neural stimulation from the electrode to at least one of the nerve bundles of the nerve trunk. Other aspects and embodiments are provided herein.

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