Microtransactions have had implementations of various sorts for about two decades now. Patronage has had implementations for about two years now. Patronage is probably already ten times the size of microtransactions, and I suspect I'm being an order of magnitude or two generous on the side of microtransactions there. My conclusion: Patronage may work, microtransactions do not.
One possibly reason is that advertising crowds out microtransactions in any practical implementation; you can either hope that your viewer has installed a microtransaction plugin and is visiting enough sites to make it worthwhile and not let the installation decay, or you can simply install ads and get 100th the price of a single transaction but get it from everybody. Microtransactions have faced a serious boil-the-ocean problem. On the other hand, under the patronage model, you get about 500-1000 people to support you with 4-5 bucks a month and now you're living a middle class lifestyle. That's not trivial, but it's not boil the ocean. (And if you can't get that, well... sorry, perhaps you're not cut out to be an internet "content creator" and live on that. I know I personally am not.)
I got that 4-5 bucks a month by running the numbers on the four campaigns I'm involved in. The averages I obtained were $7.80, $3.50, $4.50, and $3.90 per patron. 2 of those are big enough that the creators can live comfortably middle-class lifestyles on the patronage alone. One is augmenting contract cartooning work and I would imagine between the two of those things is comfortably-middle class. One of them can not on just the patronage income, but has expressed thanks on his blog for it being enough money to find a better place to live for him and his family, and the other is a now embarrassingly-oversupplied-with-money Let's Play series that's a spare time thing that certainly is worth the time the owner invests in it now. So this is not a rehash of the "microtransactions will be awesome someday in the future" argument that I've been reading; this is happening now, it's the present.
(And in all cases, when I say "comfortably middle-class", I am including both fees taken out before they get their money, taxes, and self-insuring; $60-70K a year in income is more than many people see! If they're merely making the "median US income" in cash before fees and taxes I would be less glib, though even that is impressive compared to what could be done three years ago.)
(Also, by no means am I claiming this is a random sample. You may go do your own to whatever criteria you like. But I would also reiterate that this isn't going to work for everyone, and a failed Patreon campaign isn't really the fault of either Patreon or the idea of patronage as a viable solution.)