Maybe if the a1200 was installed into a PC desktop case, but not in a classic 1200 desktop case.
It's pretty much the same space requirement as the mediator, with the difference that the busboard is connected to the expansion port pass-through by a couple of ribbon cables. The upside is it allows you a little extra flexibility in where to mount the busboard. Quite handy if you're adapting a tower, rather than installing into a custom-built job.
I've got one of these, and iirc it does 1024x768x15 nicely and 800x600x24. Can't remember exactly, as have installed a mediator SX since, and haven't played with the Ateo for a while. Some graphics corruption in the menu bars, but I assume that was my inexperienced installation of Picasso96.
You're right, the Pixel 64 is basically a cheap ISA graphics card, but it does the job nicely. Was probably quite an expensive card back in the day.