In that different world, Transmeta would actually succeed in the market of x86-compatible CPUs and, perhaps, would even come up with their own 64-bit extension. Itanium would still flop.
Or maybe, if the push came to shove, the desktops would switch to something entirely different like Alpha. Or ARM! Such event would likely force ARM to come up with their AArch64 several years sooner than it actually happened.
Transmeta wasn't a success story to start with, died before Itanium, and Intel is one of the patent holders.