The thing is, if you want a true, from the ground up 64bit architecture, you can't have really have near full 32bit backwards compatability without a massive performance penalty.
X86-64 works around this by being an extension of the X86 architecture, so it can still natively execute 32bit code with no performance loss if the OS is 32bit only - admittadly, AFAIK. Itanium can also do this with WOW64 I think, but with a bigger performance hit as I don't believe you can run X86 OSs on it. But then have you priced Itaniums lately? There is a reason why Itaniums are the joke of the IT industry.
Now, you try running Win 7/64bit against a 32bit OS with the same x86-64 based CPU, and see if you get any noticable performance drop.
Ok, now try running Windows XP or Vista on SPARC, Power6 or any other "true", from the ground up 64 bit instruction set. Oh, wait, you can't...? That's called supply and demand. Sun, IBM etc have a small enough user base they can get away with running concurrent binaries on different code bases - MS can't, realistically.
Nowt wrong wtih X86-64. Yes, I agree that a total rewrite of Windows with pure 64bit code on Itanium [or a refined version of it] with a long lead time for the major software players to rewrite their apps, and limited backwards compatabilty would have been better overall [look at what happened to hardware platforms when 486 went to Pentium - EISA and VESA buses disappeared in the space of two years to be replaced by PCI...] for hardware development, but the problem is that x86/Windows32 is so saturated in the commercial and domestic market - 75%+ - that it's simply not possible to do that.
Nothing wrong with x86-64. It does what is currently required. Maybe in a decade when GPGPU computing, their architecture being dragged into the OS - look at SnowLeopard and OpenCL for a prime example - might cause a true sea change. I'm not hopeful though.
I can see x86, horrificallly inefficient though it is in comparison to SPARC, PowerX etc in many ways, being the dominant architecture for another ten years.
Christ, I bet Intel never thought someone would be saying that in 2009 when they pumped out the initial x86 microcode...